Provider Demographics
NPI:1659666121
Name:WILLIAMS, GALE EUGENIA (RPH)
Entity Type:Individual
Prefix:
First Name:GALE
Middle Name:EUGENIA
Last Name:WILLIAMS
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 1:5037 S LINKS CIR
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23435-2684
Mailing Address - Country:US
Mailing Address - Phone:757-465-8618
Mailing Address - Fax:
Practice Address - Street 1:4200 PORTSMOUTH BLVD
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23321-2100
Practice Address - Country:US
Practice Address - Phone:757-465-8618
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-13
Last Update Date:2011-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202204168183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist