Provider Demographics
NPI:1447529979
Name:GALVIN, KENNETH R (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:R
Last Name:GALVIN
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 1:801 SE 17TH ST
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-4424
Mailing Address - Country:US
Mailing Address - Phone:352-629-6188
Mailing Address - Fax:352-629-2979
Practice Address - Street 1:801 SE 17TH ST
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-4424
Practice Address - Country:US
Practice Address - Phone:352-629-6188
Practice Address - Fax:352-629-2979
Is Sole Proprietor?:No
Enumeration Date:2011-12-29
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0032604183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist