1205172053 NPI number — MRS. GRETCHEN DENIKE IRION PHARM.D.

Table of content: MRS. GRETCHEN DENIKE IRION PHARM.D. (NPI 1205172053)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205172053 NPI number — MRS. GRETCHEN DENIKE IRION PHARM.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
IRION
Provider First Name:
GRETCHEN
Provider Middle Name:
DENIKE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
PHARM.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DENIKE
Provider Other First Name:
GRETCHEN
Provider Other Middle Name:
ANNE
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
B.S.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1205172053
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/26/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
170 ALAMEDA DE LAS PULGAS
Provider Second Line Business Mailing Address:
PHARMACY DEPARTMENT
Provider Business Mailing Address City Name:
REDWOOD CITY
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94062-2751
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
650-367-5534
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
170 ALAMEDA DE LAS PULGAS
Provider Second Line Business Practice Location Address:
PHARMACY DEPARTMENT
Provider Business Practice Location Address City Name:
REDWOOD CITY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94062-2751
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
650-367-5534
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/26/2012

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  RPH 49535 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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