Provider Demographics
NPI:1215530308
Name:TAYLOR, GREGORY DOUGLAS (PHARMD)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:DOUGLAS
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 PERIMETER DR
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113-7314
Mailing Address - Country:US
Mailing Address - Phone:804-419-8141
Mailing Address - Fax:804-419-8151
Practice Address - Street 1:201 PERIMETER DR
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113-7314
Practice Address - Country:US
Practice Address - Phone:804-419-8141
Practice Address - Fax:804-419-8151
Is Sole Proprietor?:No
Enumeration Date:2020-11-19
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202215170183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist