Provider Demographics
NPI:1598071250
Name:GAROFOLI, GRETCHEN M (PHARMD, BCACP)
Entity Type:Individual
Prefix:
First Name:GRETCHEN
Middle Name:M
Last Name:GAROFOLI
Suffix:
Gender:F
Credentials:PHARMD, BCACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1124 HEALTH SCIENCES CENTER
Mailing Address - Street 2:P.O. BOX 9520
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26506
Mailing Address - Country:US
Mailing Address - Phone:304-293-1456
Mailing Address - Fax:304-293-7672
Practice Address - Street 1:215 DON KNOTTS BLVD
Practice Address - Street 2:SUITE 120
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26501-6734
Practice Address - Country:US
Practice Address - Phone:304-225-7979
Practice Address - Fax:304-225-3784
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-19
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP443654183500000X
VA0202209425183500000X
WVRP0007580183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist