Provider Demographics
NPI:1780951681
Name:GROSS, CHRISTOPHER MARTINEZ (PHARM D)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:MARTINEZ
Last Name:GROSS
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2535 WILLIAM PENN HWY
Mailing Address - Street 2:
Mailing Address - City:PALMER TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:18045-5222
Mailing Address - Country:US
Mailing Address - Phone:610-252-3538
Mailing Address - Fax:
Practice Address - Street 1:2535 WILLIAM PENN HWY
Practice Address - Street 2:
Practice Address - City:PALMER TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:18045-5222
Practice Address - Country:US
Practice Address - Phone:610-252-3538
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-20
Last Update Date:2011-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP441519183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist