MEDICARE: HEATHER GATES PHARM D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	19968	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1477575116	OTHER		NPI

General Provider Information

NPI Number	:	1316071681
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER GATES PHARM D

Provider Business Mailing Address
First Line	:	3804 G ST
Second Line	:
City	:	AMANA
State	:	IA
Zip	:	52203-8017
Country	:	US
Telephone Number	:	319-622-4036
Fax Number	:

Provider Business Practice Location Address
First Line	:	3400 EDGEWOOD RD SW
Second Line	:
City	:	CEDAR RAPIDS
State	:	IA
Zip	:	52404-7214
Country	:	US
Telephone Number	:	193-396-4777
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/16/2007
Last Update Date	:	12/17/2021

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Directions to “ HEATHER GATES PHARM D” Practice Location

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