Provider Demographics
NPI:1548592017
Name:GALLAGHER & GALLAGHER
Entity Type:Organization
Organization Name:GALLAGHER & GALLAGHER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:HAHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-625-0925
Mailing Address - Street 1:149 E WATER ST
Mailing Address - Street 2:
Mailing Address - City:SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:44870-2525
Mailing Address - Country:US
Mailing Address - Phone:419-625-0925
Mailing Address - Fax:419-625-1994
Practice Address - Street 1:149 E WATER ST
Practice Address - Street 2:
Practice Address - City:SANDUSKY
Practice Address - State:OH
Practice Address - Zip Code:44870-2525
Practice Address - Country:US
Practice Address - Phone:419-625-0925
Practice Address - Fax:419-625-1994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-08
Last Update Date:2012-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH46193305R00000X
OH46192305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0469792Medicaid
OH0469792Medicaid
OHGA0499822Medicare PIN