Provider Demographics
NPI:1881098598
Name:GALLAHER, BRIAN NOLAN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:NOLAN
Last Name:GALLAHER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 E BROADWAY
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37821-2323
Mailing Address - Country:US
Mailing Address - Phone:423-623-0364
Mailing Address - Fax:423-623-7294
Practice Address - Street 1:102 E BROADWAY
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:TN
Practice Address - Zip Code:37821-2323
Practice Address - Country:US
Practice Address - Phone:423-623-0364
Practice Address - Fax:423-623-7294
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-09
Last Update Date:2014-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN38586183500000X
NC24440183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist