Provider Demographics
NPI:1881920197
Name:GAWLIKOWSKI, ANDREW EDWARD (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:EDWARD
Last Name:GAWLIKOWSKI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1524 3RD AVE S
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405-2407
Mailing Address - Country:US
Mailing Address - Phone:406-761-4764
Mailing Address - Fax:
Practice Address - Street 1:625 CENTRAL AVE W
Practice Address - Street 2:SUITE 105
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59404-2874
Practice Address - Country:US
Practice Address - Phone:406-452-3713
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-20
Last Update Date:2009-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT5855183500000X
DEA1-0003584183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist