Gravitte, Alton Paul

Gravitte, Alton Paul is an individual health care provider with primary practice located at 114 E Lebanon St , Mount Airy NC 27030-3662. He recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as his primary health care specialty. Gravitte, Alton Paul can be contacted via phone (336) 786-2177.

Contact Information

Primary practice address
114 E Lebanon St Mount Airy NC 27030-3662
Fax: (336) 786-1556
Website:

Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X 4991 North Carolina

Profile Details

NPI number 1164732269
LBN Legal business name Gravitte, Alton Paul
Credentials PHARMACIST
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 7th, 2010
Last updated Oct 7th, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164732269 NPPES
North Carolina MEDICAID NC0865492

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