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General NPI Number Information
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NPI Number | 1134370455
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Entity Type | Organization
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Legal Business Name | GALLERY PHARMACIES INC
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Dates
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Enumeration Date | 10/06/2008
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Last Update Date | 02/12/2010
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Provider Practice Location Address
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Address Line | 141 WEST BROADWAY
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City | PATERSON
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State | NJ
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Zip | 07522
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Country | US
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Telephone | 973-904-3404
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Fax | 973-720-8411
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Provider Business Mailing Address
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Address Line | 141 WEST BROADWAY
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City | PATERSON
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State | NJ
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Zip | 07522
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Country | US
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Telephone | 973-904-3404
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Fax | 973-720-8411
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | GAURAV MAHATMA
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Credential |
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Telephone | 973-904-3404
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 28RS00683100
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License Number State | NJ
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