Provider Demographics
NPI:1578260998
Name:GALES, LISA LIANNE (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:LIANNE
Last Name:GALES
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 236
Mailing Address - Street 2:
Mailing Address - City:COLDWATER
Mailing Address - State:KS
Mailing Address - Zip Code:67029-0236
Mailing Address - Country:US
Mailing Address - Phone:620-582-2134
Mailing Address - Fax:620-582-2920
Practice Address - Street 1:113 E MAIN ST
Practice Address - Street 2:
Practice Address - City:COLDWATER
Practice Address - State:KS
Practice Address - Zip Code:67029-9757
Practice Address - Country:US
Practice Address - Phone:620-582-2134
Practice Address - Fax:620-582-2190
Is Sole Proprietor?:No
Enumeration Date:2023-02-15
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11482183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist