Provider Demographics
NPI:1043559883
Name:GIAMANCO, ANDREA D (RPH)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:D
Last Name:GIAMANCO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6999 JACKRABBIT LN
Mailing Address - Street 2:
Mailing Address - City:BELGRADE
Mailing Address - State:MT
Mailing Address - Zip Code:59714-8961
Mailing Address - Country:US
Mailing Address - Phone:406-360-6241
Mailing Address - Fax:
Practice Address - Street 1:6999 JACKRABBIT LN
Practice Address - Street 2:
Practice Address - City:BELGRADE
Practice Address - State:MT
Practice Address - Zip Code:59714-8961
Practice Address - Country:US
Practice Address - Phone:406-388-1696
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-13
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT50981835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist