MEDICARE: GANTT GALLOWAY PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1835P1200X	Pharmacotherapy Pharmacist	42537	CA

General Provider Information

NPI Number	:	1396690616
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GANTT GALLOWAY PHARMD

Provider Business Mailing Address
First Line	:	2909 ASHBY AVE
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94705-2321
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2909 ASHBY AVE
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94705-2321
Country	:	US
Telephone Number	:	510-459-8269
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/02/2026
Last Update Date	:	03/02/2026

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Directions to “ GANTT GALLOWAY PHARMD” Practice Location

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