Provider Demographics
NPI:1023237583
Name:GUNDLACH, CATHERINE A (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:A
Last Name:GUNDLACH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:190 E BANNOCK ST
Mailing Address - Street 2:INPATIENT PHARMACY
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83712-6241
Mailing Address - Country:US
Mailing Address - Phone:208-381-2476
Mailing Address - Fax:208-381-3554
Practice Address - Street 1:190 E BANNOCK ST
Practice Address - Street 2:INPATIENT PHARMACY
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83712-6241
Practice Address - Country:US
Practice Address - Phone:208-381-2476
Practice Address - Fax:208-381-3554
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IDP51931835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy