Provider Demographics
NPI:1821437138
Name:BATHKE, GRACE SALVATERA (RPH)
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:SALVATERA
Last Name:BATHKE
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 1:1953 CHELSEA CT
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93906-5412
Mailing Address - Country:US
Mailing Address - Phone:831-449-7523
Mailing Address - Fax:
Practice Address - Street 1:880 NORTHRIDGE CTR
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93906-2007
Practice Address - Country:US
Practice Address - Phone:831-449-2481
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-19
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 51794183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist