Healthcare Provider Details

I. General information

NPI: 1174525745
Provider Name (Legal Business Name): GAIL F ORR RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/12/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

TOM'S MAD PRICER DISCOUNT FOOD & DRUGS 503 WALNUT
MURPHYSBORO IL
62966
US

IV. Provider business mailing address

6530 HIGHWAY 13 W
HARRISBURG IL
62946-4142
US

V. Phone/Fax

Practice location:
  • Phone: 618-687-1187
  • Fax: 618-684-8633
Mailing address:
  • Phone: 618-252-3537
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number028161
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: