Provider Demographics
NPI:1447404751
Name:GRAYSON, EVERETTE MONROE (RPH)
Entity type:Individual
Prefix:MR
First Name:EVERETTE
Middle Name:MONROE
Last Name:GRAYSON
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 SHADOW VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-8341
Mailing Address - Country:US
Mailing Address - Phone:336-841-2033
Mailing Address - Fax:
Practice Address - Street 1:214 SHADOW VALLEY RD
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-8341
Practice Address - Country:US
Practice Address - Phone:336-841-2033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-13
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist