Healthcare Provider Details

I. General information

NPI: 1760506562
Provider Name (Legal Business Name): SUSAN ZINTNER-GALLOWAY RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 SWEDESBORO RD SUITE 20
MULLICA HILL NJ
08062-1800
US

IV. Provider business mailing address

163 HIGH ST
MULLICA HILL NJ
08062-9571
US

V. Phone/Fax

Practice location:
  • Phone: 856-223-0177
  • Fax: 856-223-0168
Mailing address:
  • Phone: 856-478-0504
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI02042100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: