Provider Demographics
NPI:1568744555
Name:GETTIS, ANDREW D (PHARMD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:D
Last Name:GETTIS
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 1:204 KELLER AVE N
Mailing Address - Street 2:PO BOX 17
Mailing Address - City:AMERY
Mailing Address - State:WI
Mailing Address - Zip Code:54001-1036
Mailing Address - Country:US
Mailing Address - Phone:715-268-8121
Mailing Address - Fax:715-268-4733
Practice Address - Street 1:204 KELLER AVE N
Practice Address - Street 2:
Practice Address - City:AMERY
Practice Address - State:WI
Practice Address - Zip Code:54001-1036
Practice Address - Country:US
Practice Address - Phone:715-268-8121
Practice Address - Fax:715-268-4733
Is Sole Proprietor?:No
Enumeration Date:2011-09-15
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI16122-040183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist