Provider Demographics
NPI:1033223573
Name:WILLIAM J. GATTI, INC
Entity Type:Organization
Organization Name:WILLIAM J. GATTI, INC
Other - Org Name:GATTI PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:C
Authorized Official - Last Name:SMITH COONEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:724-349-4200
Mailing Address - Street 1:PO BOX 105
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17821
Mailing Address - Country:US
Mailing Address - Phone:724-349-4200
Mailing Address - Fax:724-349-2567
Practice Address - Street 1:1024 PHILADELPHIA ST.
Practice Address - Street 2:
Practice Address - City:INDIANA
Practice Address - State:PA
Practice Address - Zip Code:15701
Practice Address - Country:US
Practice Address - Phone:724-349-4200
Practice Address - Fax:724-349-2567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-19
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP410844L3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1477334Medicaid
PA1081810001Medicare ID - Type Unspecified