Provider Demographics
NPI:1174891626
Name:GRGEORY, SABRINA LEAH (PHARMD)
Entity type:Individual
Prefix:DR
First Name:SABRINA
Middle Name:LEAH
Last Name:GRGEORY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5901 BRENNAN AVE
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80923-4100
Mailing Address - Country:US
Mailing Address - Phone:719-694-4968
Mailing Address - Fax:
Practice Address - Street 1:5901 BRENNAN AVE
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80923-4100
Practice Address - Country:US
Practice Address - Phone:719-694-4968
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-12
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO20032531835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist