Provider Demographics
NPI:1114187309
Name:GALKIN, ANITA IVY (BSC RPH)
Entity Type:Individual
Prefix:MS
First Name:ANITA
Middle Name:IVY
Last Name:GALKIN
Suffix:
Gender:F
Credentials:BSC RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 W BUTLER AVE
Mailing Address - Street 2:
Mailing Address - City:CHALFONT
Mailing Address - State:PA
Mailing Address - Zip Code:18914-2218
Mailing Address - Country:US
Mailing Address - Phone:215-997-3693
Mailing Address - Fax:215-997-5535
Practice Address - Street 1:505 W BUTLER AVE
Practice Address - Street 2:
Practice Address - City:CHALFONT
Practice Address - State:PA
Practice Address - Zip Code:18914-2218
Practice Address - Country:US
Practice Address - Phone:215-997-3693
Practice Address - Fax:215-997-5536
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-11
Last Update Date:2010-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP030611L183500000X
NJ28R101684200183500000X
FLPS22837183500000X
TX2775183500000X
MD43977183500000X
VA202008063183500000X
IL51290440183500000X
MD11191183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist