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General NPI Number Information
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NPI Number | 1275605784
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Entity Type | Organization
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Legal Business Name | GALLERY PHARMACY INC
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Dates
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Enumeration Date | 11/14/2006
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Last Update Date | 07/03/2008
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Provider Practice Location Address
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Address Line | 1108 SOUTH PACIFIC HWY
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City | LONG BEACH
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State | WA
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Zip | 98631-1037
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Country | US
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Telephone | 360-642-4244
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Fax | 360-642-4245
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Provider Business Mailing Address
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Address Line | PO BOX 1078 1108 S PACIFIC HWY
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City | LONG BEACH
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State | WA
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Zip | 98631
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Country | US
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Telephone | 360-642-4244
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Fax | 360-642-4245
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Authorized Official
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Title or Position | PHARMACY MANAGER
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Name | MRS. SHEILA DIANE WELLER
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Credential | RPH
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Telephone | 360-642-4244
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | CF00003996
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License Number State | WA
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