Basic Information
| Provider Information | |||||||||
| NPI: | 1417219460 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHARNESKY | ||||||||
| FirstName: | GREGORY | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | RPH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3020 RONAN DR | ||||||||
| Address2: | |||||||||
| City: | BILLINGS | ||||||||
| State: | MT | ||||||||
| PostalCode: | 591020935 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4068961671 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2115 CENTRAL AVE | ||||||||
| Address2: | |||||||||
| City: | BILLINGS | ||||||||
| State: | MT | ||||||||
| PostalCode: | 591024741 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4066566500 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/14/2012 | ||||||||
| LastUpdateDate: | 06/14/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 3847 | MT | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.