Provider Demographics
NPI:1811217441
Name:GALVIN, BRIAN DAVID (RPH)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:DAVID
Last Name:GALVIN
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 1:400 MILLS AVE
Mailing Address - Street 2:UNIT 304
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29605-4158
Mailing Address - Country:US
Mailing Address - Phone:864-325-5330
Mailing Address - Fax:
Practice Address - Street 1:400 MILLS AVE
Practice Address - Street 2:UNIT 304
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-4158
Practice Address - Country:US
Practice Address - Phone:864-325-5330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-05
Last Update Date:2010-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4952183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist