Provider Demographics
NPI:1689662264
Name:GALLO, PATRICK (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:
Last Name:GALLO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 BRACKEN CT
Mailing Address - Street 2:
Mailing Address - City:LIBERTY
Mailing Address - State:SC
Mailing Address - Zip Code:29657-1629
Mailing Address - Country:US
Mailing Address - Phone:864-843-2181
Mailing Address - Fax:
Practice Address - Street 1:502 ANN ST
Practice Address - Street 2:
Practice Address - City:PICKENS
Practice Address - State:SC
Practice Address - Zip Code:29671-2267
Practice Address - Country:US
Practice Address - Phone:864-878-2464
Practice Address - Fax:864-878-5108
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6017183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC6017OtherSC STATE LIC NUMBER