Healthcare Provider Details

I. General information

NPI: 1770529687
Provider Name (Legal Business Name): GALLOWAY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2995 NATIONAL AVE
SAN DIEGO CA
92113-2419
US

IV. Provider business mailing address

2995 NATIONAL AVE
SAN DIEGO CA
92113-2419
US

V. Phone/Fax

Practice location:
  • Phone: 619-525-1551
  • Fax: 619-234-1602
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPHY40669
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: SCOT TYREE
Title or Position: CEO
Credential:
Phone: 619-525-1551