Josh Aaron Gronwall, PHARMD
Individual provider Active NPI Pharmacist · Sidney, NY
NPI 1881751907 · NPPES record last updated Dec 24, 2022
Key facts
- NPI
- 1881751907
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 047453 (NY)
- Practice address
- 10 Main St
Sidney, NY 13838-1135 - Phone
- (607) 563-2166
- Fax
- (607) 563-8828
- NPI assigned
- Jan 2, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 047453 | NY | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 047453 | NY | Yes |
Addresses
Primary practice location
10 Main St
Sidney, NY 13838-1135
Mailing address
41 River St
Sidney, NY 13838-1017
Phone (607) 563-1841
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 047453 | Other | NY | PHARMACY LICENSE |
Other providers in Sidney, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 24, 2022. 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.