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General NPI Number Information
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NPI Number | 1679542161
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Entity Type | Individual
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Provider Name | TIMOTHY J. GALLEGOS RPH
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Gender | Male
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Dates
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Enumeration Date | 03/16/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 302 S TRANSIT ST
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City | LOCKPORT
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State | NY
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Zip | 14094-4851
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Country | US
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Telephone | 716-433-3733
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Fax | 716-433-3720
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Provider Business Mailing Address
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Address Line | 4631 DICKERSONVILLE RD
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City | RANSOMVILLE
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State | NY
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Zip | 14131-9752
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Country | US
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Telephone | 716-754-8186
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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 | 35898-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RP-00004045
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License Number State | NM
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 143808-1701
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License Number State | UT
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