Provider Demographics
NPI:1578612628
Name:GORR, DONNA J (RPH)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:J
Last Name:GORR
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:411 E RIVER ST
Mailing Address - Street 2:
Mailing Address - City:WHITEHALL
Mailing Address - State:MI
Mailing Address - Zip Code:49461-1146
Mailing Address - Country:US
Mailing Address - Phone:586-242-7065
Mailing Address - Fax:
Practice Address - Street 1:4171 S OCEANA DR
Practice Address - Street 2:
Practice Address - City:NEW ERA
Practice Address - State:MI
Practice Address - Zip Code:49446-9781
Practice Address - Country:US
Practice Address - Phone:231-861-6900
Practice Address - Fax:231-861-7177
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302029909183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist