Provider Demographics
NPI:1427693571
Name:MUNROE, GERARD ADRIAN (DOCTOR OF PHARMACY)
Entity type:Individual
Prefix:
First Name:GERARD
Middle Name:ADRIAN
Last Name:MUNROE
Suffix:
Gender:M
Credentials:DOCTOR OF PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1620 CHERRY BLOSSOM LN UNIT 104
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27127-3175
Mailing Address - Country:US
Mailing Address - Phone:336-650-6101
Mailing Address - Fax:
Practice Address - Street 1:204 W MAIN ST
Practice Address - Street 2:
Practice Address - City:PILOT MOUNTAIN
Practice Address - State:NC
Practice Address - Zip Code:27041-9301
Practice Address - Country:US
Practice Address - Phone:336-368-4747
Practice Address - Fax:336-368-1091
Is Sole Proprietor?:No
Enumeration Date:2019-11-13
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC28552183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist