Provider Demographics
NPI:1326323486
Name:LAUGHLIN, GAY ELLEN (RPH)
Entity Type:Individual
Prefix:MRS
First Name:GAY
Middle Name:ELLEN
Last Name:LAUGHLIN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1330 E UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50316-2460
Mailing Address - Country:US
Mailing Address - Phone:515-299-9791
Mailing Address - Fax:
Practice Address - Street 1:1330 E UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50316-2460
Practice Address - Country:US
Practice Address - Phone:515-299-9791
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-19
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA18592183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist