MEDICARE: DR. DAVID J GARRABRANDT PHARMD

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	P5019	ID

General Provider Information

NPI Number	:	1982691788
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID J GARRABRANDT PHARMD

Provider Business Mailing Address
First Line	:	500 W FORT ST
Second Line	:
City	:	BOISE
State	:	ID
Zip	:	83702-4501
Country	:	US
Telephone Number	:	208-422-1000
Fax Number	:	208-422-1198

Provider Business Practice Location Address
First Line	:	500 W FORT ST
Second Line	:
City	:	BOISE
State	:	ID
Zip	:	83702-4501
Country	:	US
Telephone Number	:	208-422-1000
Fax Number	:	208-422-1198

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

Provider Enumeration Date	:	10/05/2005
Last Update Date	:	07/08/2007

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Directions to “ DR. DAVID J GARRABRANDT PHARMD” Practice Location

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