Provider Demographics
NPI:1194079822
Name:GAINEY, WAYMON RONALD (RPH)
Entity type:Individual
Prefix:
First Name:WAYMON
Middle Name:RONALD
Last Name:GAINEY
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 1:1323 ROBIN RD
Mailing Address - Street 2:
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-3620
Mailing Address - Country:US
Mailing Address - Phone:443-932-9194
Mailing Address - Fax:
Practice Address - Street 1:1323 ROBIN RD
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-3620
Practice Address - Country:US
Practice Address - Phone:443-932-9194
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-02
Last Update Date:2014-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD182691835P1200X
NC067811835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy