Provider Demographics
NPI:1366036964
Name:GALLOWAY, KERI POWELL (PHARMD)
Entity Type:Individual
Prefix:
First Name:KERI
Middle Name:POWELL
Last Name:GALLOWAY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3318 ANDERSONVILLE HWY
Mailing Address - Street 2:
Mailing Address - City:ANDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37705-3816
Mailing Address - Country:US
Mailing Address - Phone:865-494-8444
Mailing Address - Fax:865-494-8402
Practice Address - Street 1:3318 ANDERSONVILLE HWY
Practice Address - Street 2:
Practice Address - City:ANDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37705-3816
Practice Address - Country:US
Practice Address - Phone:865-494-8444
Practice Address - Fax:865-494-8402
Is Sole Proprietor?:No
Enumeration Date:2021-02-24
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN41610183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist