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General NPI Number Information
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NPI Number | 1578612628
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Entity Type | Individual
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Provider Name | DONNA J GORR R.PH.
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Gender | Female
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Dates
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Enumeration Date | 01/09/2007
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Last Update Date | 11/13/2024
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Provider Practice Location Address
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Address Line | 4171 S OCEANA DR
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City | NEW ERA
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State | MI
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Zip | 49446-9781
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Country | US
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Telephone | 231-861-6900
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Fax | 231-861-7177
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Provider Business Mailing Address
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Address Line | 411 E RIVER ST
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City | WHITEHALL
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State | MI
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Zip | 49461-1146
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Country | US
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Telephone | 586-242-7065
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 5302029909
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License Number State | MI
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