Active NPI
Gwynetta Gallup
- Pharmacist
- Southington, CT
National Provider Identifier
1316480825
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 8213
- Practice address
- 724 Queen St
Southington, CT 06489-1505 - Phone
- (860) 621-7371
- Fax
- (860) 276-0243
- NPI assigned
- Dec 1, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 8213 | CT | Primary |
Addresses
Primary practice location
724 Queen St
Southington, CT 06489-1505
Mailing address
724 Queen St
Southington, CT 06489-1505
Phone (860) 621-7371
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8213 | CT | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Connecticut CVS Pharmacy LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1480550400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1480550400000",
"number": "1316480825",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "724 QUEEN ST",
"city": "SOUTHINGTON",
"state": "CT",
"postal_code": "064891505",
"telephone_number": "860-621-7371",
"fax_number": "860-276-0243"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "724 QUEEN ST",
"city": "SOUTHINGTON",
"state": "CT",
"postal_code": "064891505",
"telephone_number": "860-621-7371",
"fax_number": "860-276-0243"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GALLUP",
"first_name": "GWYNETTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-12-01",
"last_updated": "2016-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CT",
"license": "8213",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southington, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.