Provider Demographics
NPI:1407853286
Name:GLEASON, PATRICK P (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:P
Last Name:GLEASON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3101 CANTERBURY DR
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55431-3229
Mailing Address - Country:US
Mailing Address - Phone:952-835-5998
Mailing Address - Fax:
Practice Address - Street 1:1305 CORPORATE CENTER DRIVE
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55121-2095
Practice Address - Country:US
Practice Address - Phone:651-286-4190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN115547-5183500000X, 1835P1200X
PARP-039755-T183500000X, 1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered183500000XPharmacy Service ProvidersPharmacist
Not Answered1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy