Provider Demographics
NPI:1891820213
Name:GALLAGHER, SAMANTHA T (RPH)
Entity Type:Individual
Prefix:MS
First Name:SAMANTHA
Middle Name:T
Last Name:GALLAGHER
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 1:2220 GOSHAWK CT
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34105-2553
Mailing Address - Country:US
Mailing Address - Phone:239-263-4490
Mailing Address - Fax:
Practice Address - Street 1:700 2ND AVE N
Practice Address - Street 2:SUITE 101
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5756
Practice Address - Country:US
Practice Address - Phone:239-263-4490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS 26606183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist