Provider Demographics
NPI:1518010743
Name:GAISER, DARLA JAN (RPH)
Entity Type:Individual
Prefix:MRS
First Name:DARLA
Middle Name:JAN
Last Name:GAISER
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 1:37939 MACE CEMETERY RD
Mailing Address - Street 2:
Mailing Address - City:RADCLIFF
Mailing Address - State:OH
Mailing Address - Zip Code:45695-8962
Mailing Address - Country:US
Mailing Address - Phone:740-669-0031
Mailing Address - Fax:740-446-5846
Practice Address - Street 1:90 JACKSON PIKE
Practice Address - Street 2:HOLZER FAMILY PHARMACY
Practice Address - City:GALLIPOLIS
Practice Address - State:OH
Practice Address - Zip Code:45631-1560
Practice Address - Country:US
Practice Address - Phone:740-446-5884
Practice Address - Fax:740-446-5846
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-3-114481835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric