Provider Demographics
NPI:1225511025
Name:GALLI, ISAAC JOHN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ISAAC
Middle Name:JOHN
Last Name:GALLI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:ISAAC
Other - Middle Name:JOHN LANG
Other - Last Name:GALLI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:2628 RENWICK WAY
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:OH
Mailing Address - Zip Code:45373-9258
Mailing Address - Country:US
Mailing Address - Phone:937-573-6536
Mailing Address - Fax:
Practice Address - Street 1:103 CORPORATE LAKE DR STE B
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-7290
Practice Address - Country:US
Practice Address - Phone:573-256-4279
Practice Address - Fax:573-442-6429
Is Sole Proprietor?:No
Enumeration Date:2018-09-08
Last Update Date:2018-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03337239183500000X
KYI11895183500000X
MO2018024637183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist