Provider Demographics
NPI:1700987690
Name:GAMRATH, GERALD ELMO (RPH)
Entity Type:Individual
Prefix:MR
First Name:GERALD
Middle Name:ELMO
Last Name:GAMRATH
Suffix:
Gender:M
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:PO BOX 1518
Mailing Address - Street 2:
Mailing Address - City:BAKER
Mailing Address - State:MT
Mailing Address - Zip Code:59313-1518
Mailing Address - Country:US
Mailing Address - Phone:406-778-2418
Mailing Address - Fax:406-778-3460
Practice Address - Street 1:21 SOUTH MAIN
Practice Address - Street 2:
Practice Address - City:BAKER
Practice Address - State:MT
Practice Address - Zip Code:59313-1018
Practice Address - Country:US
Practice Address - Phone:406-778-2418
Practice Address - Fax:406-778-3460
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT2988183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist