Provider Demographics
NPI:1144957770
Name:LANCE, GREGGORY TRENTON II (PHARMD)
Entity type:Individual
Prefix:DR
First Name:GREGGORY
Middle Name:TRENTON
Last Name:LANCE
Suffix:II
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:567 HIGHWAY 67 S
Mailing Address - Street 2:
Mailing Address - City:POCAHONTAS
Mailing Address - State:AR
Mailing Address - Zip Code:72455-3773
Mailing Address - Country:US
Mailing Address - Phone:870-202-2536
Mailing Address - Fax:870-202-2540
Practice Address - Street 1:567 HIGHWAY 67 S
Practice Address - Street 2:
Practice Address - City:POCAHONTAS
Practice Address - State:AR
Practice Address - Zip Code:72455-3773
Practice Address - Country:US
Practice Address - Phone:870-202-2536
Practice Address - Fax:870-202-2540
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-03
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD13234183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist