MEDICARE: DONNA J GORR R.PH.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	5302029909	MI

General Provider Information

NPI Number	:	1578612628
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONNA J GORR R.PH.

Provider Business Mailing Address
First Line	:	411 E RIVER ST
Second Line	:
City	:	WHITEHALL
State	:	MI
Zip	:	49461-1146
Country	:	US
Telephone Number	:	586-242-7065
Fax Number	:

Provider Business Practice Location Address
First Line	:	4171 S OCEANA DR
Second Line	:
City	:	NEW ERA
State	:	MI
Zip	:	49446-9781
Country	:	US
Telephone Number	:	231-861-6900
Fax Number	:	231-861-7177

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/09/2007
Last Update Date	:	11/13/2024

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Directions to “ DONNA J GORR R.PH.” Practice Location

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