Provider Demographics
NPI:1609186238
Name:GALE, DAVID CHARLES (RPH)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:CHARLES
Last Name:GALE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 SOUTHPARK DR
Mailing Address - Street 2:
Mailing Address - City:WADSWORTH
Mailing Address - State:OH
Mailing Address - Zip Code:44281-1317
Mailing Address - Country:US
Mailing Address - Phone:330-335-5166
Mailing Address - Fax:
Practice Address - Street 1:175 GREAT OAKS TRL
Practice Address - Street 2:
Practice Address - City:WADSWORTH
Practice Address - State:OH
Practice Address - Zip Code:44281-8712
Practice Address - Country:US
Practice Address - Phone:330-336-3588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-16
Last Update Date:2010-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03122236183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist