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General NPI Number Information
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NPI Number | 1659583532
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Entity Type | Individual
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Provider Name | LORI DEANN PROFIT PHARMD
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Gender | Female
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4005 ORCHARD DR
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City | MIDLAND
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State | MI
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Zip | 48670-0001
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Country | US
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Telephone | 989-839-3555
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Fax |
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Provider Business Mailing Address
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Address Line | 121 FREMONT ST
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City | CARO
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State | MI
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Zip | 48723-1433
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Country | US
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Telephone | 989-672-4482
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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 | 5302034115
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License Number State | MI
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