Provider Demographics
NPI:1255762134
Name:GALLOWAY SANDS, LLC
Entity type:Organization
Organization Name:GALLOWAY SANDS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ABHIJITKUMAR
Authorized Official - Middle Name:MA
Authorized Official - Last Name:CHAUHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-454-9090
Mailing Address - Street 1:1513 N HOWE ST
Mailing Address - Street 2:SUITE 8
Mailing Address - City:SOUTHPORT
Mailing Address - State:NC
Mailing Address - Zip Code:28461-2769
Mailing Address - Country:US
Mailing Address - Phone:910-454-9090
Mailing Address - Fax:910-454-9555
Practice Address - Street 1:1513 N HOWE ST
Practice Address - Street 2:SUITE 8
Practice Address - City:SOUTHPORT
Practice Address - State:NC
Practice Address - Zip Code:28461-2769
Practice Address - Country:US
Practice Address - Phone:910-454-9090
Practice Address - Fax:910-454-9555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-03
Last Update Date:2025-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC117553336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5704350002Medicare NSC