Provider Demographics
NPI:1033343181
Name:GALA, KALPESH C
Entity Type:Individual
Prefix:MR
First Name:KALPESH
Middle Name:C
Last Name:GALA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 N CORNING ST
Mailing Address - Street 2:
Mailing Address - City:FARWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48622-9737
Mailing Address - Country:US
Mailing Address - Phone:989-588-2599
Mailing Address - Fax:
Practice Address - Street 1:146 N CORNING ST
Practice Address - Street 2:
Practice Address - City:FARWELL
Practice Address - State:MI
Practice Address - Zip Code:48622-9737
Practice Address - Country:US
Practice Address - Phone:989-588-2599
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-04
Last Update Date:2009-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302036635183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist