Provider Demographics
NPI:1295902310
Name:GALLINA, DAMIAN J (BA, BS, RPH)
Entity type:Individual
Prefix:
First Name:DAMIAN
Middle Name:J
Last Name:GALLINA
Suffix:
Gender:M
Credentials:BA, BS, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:975 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:MEADVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16335-3354
Mailing Address - Country:US
Mailing Address - Phone:814-336-3773
Mailing Address - Fax:
Practice Address - Street 1:975 MARKET ST
Practice Address - Street 2:
Practice Address - City:MEADVILLE
Practice Address - State:PA
Practice Address - Zip Code:16335-3354
Practice Address - Country:US
Practice Address - Phone:814-336-3773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-08
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP026580L1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist