Provider Demographics
NPI:1144566225
Name:GALU ENTERPRISES INC
Entity Type:Organization
Organization Name:GALU ENTERPRISES INC
Other - Org Name:PHILLY PHARMACY II
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:LAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-979-3948
Mailing Address - Street 1:9475 ROOSEVELT BLVD STE 12
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19114-2212
Mailing Address - Country:US
Mailing Address - Phone:215-969-5180
Mailing Address - Fax:866-379-3198
Practice Address - Street 1:9475 ROOSEVELT BLVD STE 12
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19114-2212
Practice Address - Country:US
Practice Address - Phone:215-969-5180
Practice Address - Fax:866-379-3198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-18
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP482144333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3998599OtherNCPDP PROVIDER IDENTIFICATION NUMBER