Provider Demographics
NPI:1134402761
Name:GALLAGHER, DEBBIE T (RPH)
Entity type:Individual
Prefix:MRS
First Name:DEBBIE
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 1:100 EDGEWOOD DR
Mailing Address - Street 2:C/O CVS PHARMACY
Mailing Address - City:PINEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71360-5441
Mailing Address - Country:US
Mailing Address - Phone:318-473-4524
Mailing Address - Fax:
Practice Address - Street 1:100 EDGEWOOD DR
Practice Address - Street 2:C/O CVS PHARMACY
Practice Address - City:PINEVILLE
Practice Address - State:LA
Practice Address - Zip Code:71360-5441
Practice Address - Country:US
Practice Address - Phone:318-473-4524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-20
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA015934183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist