Provider Demographics
NPI:1275597916
Name:GALLOWAY, MICHAEL GARRETT (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:GARRETT
Last Name:GALLOWAY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4810 W VINE AVE
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-9119
Mailing Address - Country:US
Mailing Address - Phone:599-636-2605
Mailing Address - Fax:559-732-3938
Practice Address - Street 1:5201 W GOSHEN AVE
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291-8619
Practice Address - Country:US
Practice Address - Phone:559-738-9487
Practice Address - Fax:559-732-3938
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37148183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist