Individual
CHARLES CARLON GRUBB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
94 MONTAUK HWY UNIT A, EAST MORICHES, NY 11940-1156
(631) 874-3784
Mailing address
PO BOX 625, BRIDGEHAMPTON, NY 11932-0625
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
025901
NY
Other
Enumeration date
05/09/2011
Last updated
05/09/2011
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