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
Phone: (336) 786-2177
Fax: (336) 786-1556
Website:
Health care specialties
| Specialty | Code | License # | 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 16 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1164732269 | NPPES |
| North Carolina | MEDICAID | NC0865492 |
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