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General NPI Number Information
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NPI Number | 1104651629
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Entity Type | Individual
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Provider Name | PATRICK JOSEPH GRAMATA PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 09/04/2024
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Last Update Date | 06/13/2025
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Provider Practice Location Address
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Address Line | 250 SOUTH EAGLE RD.
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City | EAGLE
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State | ID
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Zip | 83616
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Country | US
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Telephone | 208-939-9854
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Fax | 208-939-2721
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Provider Business Mailing Address
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Address Line | 633 POLARIS DR
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City | ENCINITAS
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State | CA
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Zip | 92024-2483
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Country | US
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Telephone | 619-708-9112
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH49613
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License Number State | CA
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