Gary F. Jerge, RPH
Individual provider Active NPI Pharmacist · Medina, NY
NPI 1386976579 · NPPES record last updated Feb 12, 2010
Key facts
- NPI
- 1386976579
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 033783 (NY)
- Practice address
- 11200 Maple Ridge Rd.
Tops Pharmacy
Medina, NY 14103-1844 - Phone
- (585) 798-1629
- Fax
- (585) 798-1623
- NPI assigned
- Feb 12, 2010
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 033783 | NY | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 033783 | NY | Yes |
Addresses
Primary practice location
11200 Maple Ridge Rd.
Tops Pharmacy
Medina, NY 14103-1844
Mailing address
11200 Maple Ridge Rd.
Tops Pharmacy
Medina, NY 14103-1844
Phone (585) 798-1629
Other providers in Medina, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 12, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.