Provider Demographics
NPI:1255647657
Name:GALBREATH, TODD JAMES (BA RPH)
Entity type:Individual
Prefix:MR
First Name:TODD
Middle Name:JAMES
Last Name:GALBREATH
Suffix:
Gender:M
Credentials:BA RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6002
Mailing Address - Street 2:ALTRU RETAIL PHARMACY
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58206-6002
Mailing Address - Country:US
Mailing Address - Phone:701-780-3447
Mailing Address - Fax:701-780-3442
Practice Address - Street 1:1200 SO. COLUMBIA RD.
Practice Address - Street 2:ALTRU RETAIL PHARMACY
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58206-6002
Practice Address - Country:US
Practice Address - Phone:701-780-3447
Practice Address - Fax:701-780-3442
Is Sole Proprietor?:No
Enumeration Date:2010-08-23
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND4359183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist