Provider Demographics
NPI:1700883410
Name:GROTHE, DALE ROBERT (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:DALE
Middle Name:ROBERT
Last Name:GROTHE
Suffix:
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 MARSHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:COLLEGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19426-3857
Mailing Address - Country:US
Mailing Address - Phone:610-831-5432
Mailing Address - Fax:
Practice Address - Street 1:14 MARSHWOOD DR
Practice Address - Street 2:
Practice Address - City:COLLEGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:19426-3857
Practice Address - Country:US
Practice Address - Phone:610-831-5432
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD104411835P1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1300XPharmacy Service ProvidersPharmacistPsychiatric