Provider Demographics
NPI:1780921908
Name:GIAMMONA, KATIE ERIN (PHARMD)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:ERIN
Last Name:GIAMMONA
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 1:1680 SUNFLOWER DR
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59802-3304
Mailing Address - Country:US
Mailing Address - Phone:406-370-6289
Mailing Address - Fax:
Practice Address - Street 1:2230 N RESERVE ST
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59808-1321
Practice Address - Country:US
Practice Address - Phone:406-728-1118
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-08
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT5676183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist