Provider Demographics
NPI:1053606160
Name:GRATZ, GABRIEL (PHARM D)
Entity type:Individual
Prefix:
First Name:GABRIEL
Middle Name:
Last Name:GRATZ
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WILLISTON
Mailing Address - State:ND
Mailing Address - Zip Code:58801-5303
Mailing Address - Country:US
Mailing Address - Phone:701-572-6721
Mailing Address - Fax:701-572-6723
Practice Address - Street 1:317 MAIN ST
Practice Address - Street 2:
Practice Address - City:WILLISTON
Practice Address - State:ND
Practice Address - Zip Code:58801-5303
Practice Address - Country:US
Practice Address - Phone:701-572-6721
Practice Address - Fax:701-572-6723
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-16
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN118940183500000X
NDRPH5625183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist