Provider Demographics
NPI:1306446927
Name:GREIMAN, TRISTYN LYN (PHARMD, RPH)
Entity type:Individual
Prefix:
First Name:TRISTYN
Middle Name:LYN
Last Name:GREIMAN
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:TRISTYN
Other - Middle Name:LYN
Other - Last Name:PRITTERS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD, RPH
Mailing Address - Street 1:1381 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006-2846
Mailing Address - Country:US
Mailing Address - Phone:830-816-3587
Mailing Address - Fax:830-816-2051
Practice Address - Street 1:1381 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-2846
Practice Address - Country:US
Practice Address - Phone:830-816-3587
Practice Address - Fax:830-816-2051
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-01
Last Update Date:2020-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64960183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist