Healthcare Provider Details

I. General information

NPI: 1063083657
Provider Name (Legal Business Name): ALISON NICOLE GRGAT PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2021
Last Update Date: 07/06/2021
Certification Date: 07/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10701 EAST BLVD
CLEVELAND OH
44106-1702
US

IV. Provider business mailing address

6174 WARBLERS ROOST
BRECKSVILLE OH
44141-1752
US

V. Phone/Fax

Practice location:
  • Phone: 216-791-3800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03440732
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: