Provider Demographics
NPI:1720593262
Name:GALLASPIE, JAMIE LYNN (PHARMD)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:LYNN
Last Name:GALLASPIE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 FIELDSTONE CT
Mailing Address - Street 2:
Mailing Address - City:WAPAKONETA
Mailing Address - State:OH
Mailing Address - Zip Code:45895-9467
Mailing Address - Country:US
Mailing Address - Phone:419-303-4475
Mailing Address - Fax:
Practice Address - Street 1:230 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BELLEFONTAINE
Practice Address - State:OH
Practice Address - Zip Code:43311-1702
Practice Address - Country:US
Practice Address - Phone:937-599-2314
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-06
Last Update Date:2017-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03129774183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist