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General NPI Number Information
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NPI Number | 1952794885
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Entity Type | Individual
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Provider Name | LORI P. GRANBERRY RPH
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Gender | Female
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Dates
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Enumeration Date | 03/17/2015
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Last Update Date | 03/17/2015
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Provider Practice Location Address
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Address Line | 2131 ROSS CLARK CIRCLE
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City | DOTHAN
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State | AL
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Zip | 36301
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Country | US
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Telephone | 334-677-4665
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Fax | 334-793-1983
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Provider Business Mailing Address
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Address Line | 2131 ROSS CLARK CIRCLE
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City | DOTHAN
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State | AL
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Zip | 36301
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Country | US
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Telephone | 334-677-4665
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Fax | 334-793-1983
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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 | 11076
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS0022932
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License Number State | FL
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