Provider Demographics
NPI:1295340206
Name:GRIMALDI, DANIELLE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:
Last Name:GRIMALDI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2587 ZION CT
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99507-2151
Mailing Address - Country:US
Mailing Address - Phone:646-479-1648
Mailing Address - Fax:
Practice Address - Street 1:4800 CORDOVA ST
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-7218
Practice Address - Country:US
Practice Address - Phone:907-564-2249
Practice Address - Fax:907-564-3893
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-15
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKPHAP1929183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty