Provider Demographics
NPI:1841609955
Name:GALLOWAY, JOSEPH RICHMOND JR (RPH)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:RICHMOND
Last Name:GALLOWAY
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 769
Mailing Address - Street 2:
Mailing Address - City:SUPPLY
Mailing Address - State:NC
Mailing Address - Zip Code:28462-0769
Mailing Address - Country:US
Mailing Address - Phone:910-754-7200
Mailing Address - Fax:910-754-7555
Practice Address - Street 1:58 PHYSICIANS DR NW
Practice Address - Street 2:SUITE 5
Practice Address - City:SUPPLY
Practice Address - State:NC
Practice Address - Zip Code:28462-4215
Practice Address - Country:US
Practice Address - Phone:910-754-7200
Practice Address - Fax:910-754-7555
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-04
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC08097183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist