Provider Demographics
NPI:1881753622
Name:GAROFOLI, GARY P (RPH)
Entity type:Individual
Prefix:MR
First Name:GARY
Middle Name:P
Last Name:GAROFOLI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 3 BOX 337
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16601-9216
Mailing Address - Country:US
Mailing Address - Phone:814-942-8364
Mailing Address - Fax:
Practice Address - Street 1:RR 3 BOX 337
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16601-9216
Practice Address - Country:US
Practice Address - Phone:814-942-8364
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP034458L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist