Basic Information
| Provider Information | |||||||||
| NPI: | 1790764942 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GARNER | ||||||||
| FirstName: | GALE | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | R.PH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 130 WINDMILL DR | ||||||||
| Address2: | |||||||||
| City: | PADUCAH | ||||||||
| State: | KY | ||||||||
| PostalCode: | 420015955 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2705548063 | ||||||||
| FaxNumber: | 2704770113 | ||||||||
| Practice Location | |||||||||
| Address1: | 3524 PARK PLAZA RD | ||||||||
| Address2: | |||||||||
| City: | PADUCAH | ||||||||
| State: | KY | ||||||||
| PostalCode: | 420018900 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2704424579 | ||||||||
| FaxNumber: | 2704500112 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/14/2006 | ||||||||
| LastUpdateDate: | 07/29/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 6356 | KY | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.