Healthcare Provider Details

I. General information

NPI: 1013222769
Provider Name (Legal Business Name): MS. NATALIE AUGUSTINE GRAMLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: NATALIE ANN AUGUSTINE R.PH.

II. Dates (important events)

Enumeration Date: 08/18/2010
Last Update Date: 08/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3311 PENN AVE
WEST LAWN PA
19609-1436
US

IV. Provider business mailing address

233 ATLANTIC AVE
SINKING SPRING PA
19608-9531
US

V. Phone/Fax

Practice location:
  • Phone: 610-678-1119
  • Fax: 610-678-8470
Mailing address:
  • Phone: 610-743-3044
  • Fax: 610-743-3044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP441020
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: