Provider Demographics
NPI:1316291131
Name:HERR, GREGORY CLAUDE (RPH)
Entity type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:CLAUDE
Last Name:HERR
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4551 FORBES BLVD
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-4325
Mailing Address - Country:US
Mailing Address - Phone:301-918-6519
Mailing Address - Fax:
Practice Address - Street 1:4551 FORBES BLVD
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-4325
Practice Address - Country:US
Practice Address - Phone:301-918-6519
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-31
Last Update Date:2012-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD13285183500000X
VA0202011163183500000X
DE1-0001883183500000X
PARP030075L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist