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General NPI Number Information
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NPI Number | 1548995228
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Entity Type | Individual
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Provider Name | JENNIFER M GALLIVAN PHARMD
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Gender | Female
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Dates
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Enumeration Date | 07/18/2022
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Last Update Date | 07/18/2022
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Provider Practice Location Address
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Address Line | 9197 READING RD
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City | CINCINNATI
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State | OH
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Zip | 45215-3348
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Country | US
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Telephone | 513-733-8550
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Fax |
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Provider Business Mailing Address
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Address Line | 3223 PHOENIX AVE
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City | CINCINNATI
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State | OH
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Zip | 45211-3543
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Country | US
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Telephone | 513-633-6548
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 05440979
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License Number State | OH
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