Provider Demographics
NPI:1720080146
Name:GALLAHAN, WILLIAM B (PHARMD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:B
Last Name:GALLAHAN
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 1:3220 RIVERVIEW DR
Mailing Address - Street 2:
Mailing Address - City:COLONIAL BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:22443-4704
Mailing Address - Country:US
Mailing Address - Phone:804-224-0972
Mailing Address - Fax:540-663-4275
Practice Address - Street 1:15427 DAHLGREN RD
Practice Address - Street 2:
Practice Address - City:KING GEORGE
Practice Address - State:VA
Practice Address - Zip Code:22485-5619
Practice Address - Country:US
Practice Address - Phone:540-663-2665
Practice Address - Fax:540-663-4275
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202004822183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist