Provider Demographics
NPI:1083044747
Name:GRANDO, DONNA JEAN (PHARMD)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:JEAN
Last Name:GRANDO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 ROUTE 37 W
Mailing Address - Street 2:CMC PHARMACY DEPT.
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-6423
Mailing Address - Country:US
Mailing Address - Phone:732-557-8000
Mailing Address - Fax:732-557-2125
Practice Address - Street 1:99 ROUTE 37 W
Practice Address - Street 2:CMC PHARMACY DEPT.
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-6423
Practice Address - Country:US
Practice Address - Phone:732-557-8000
Practice Address - Fax:732-557-2125
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-16
Last Update Date:2013-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03296300183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist