Provider Demographics
NPI:1336584382
Name:GALUSHA, HARRY L II (PD)
Entity Type:Individual
Prefix:
First Name:HARRY
Middle Name:L
Last Name:GALUSHA
Suffix:II
Gender:M
Credentials:PD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2015 HILLSBOROUGH LN
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72212-3730
Mailing Address - Country:US
Mailing Address - Phone:501-225-8814
Mailing Address - Fax:
Practice Address - Street 1:2015 HILLSBOROUGH LN
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72212-3730
Practice Address - Country:US
Practice Address - Phone:501-225-8814
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-03
Last Update Date:2013-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR5620183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist