Provider Demographics
NPI:1124399431
Name:CHRISTOPHER H CUTRER DBA GORMAN PHARMACY
Entity Type:Organization
Organization Name:CHRISTOPHER H CUTRER DBA GORMAN PHARMACY
Other - Org Name:GORMAN PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PIC---OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:HARRIS
Authorized Official - Last Name:CUTRER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:254-734-2859
Mailing Address - Street 1:PO BOX 608
Mailing Address - Street 2:117 S. KENT ST
Mailing Address - City:GORMAN
Mailing Address - State:TX
Mailing Address - Zip Code:76454-0608
Mailing Address - Country:US
Mailing Address - Phone:254-734-2859
Mailing Address - Fax:254-734-2859
Practice Address - Street 1:117 S KENT ST
Practice Address - Street 2:
Practice Address - City:GORMAN
Practice Address - State:TX
Practice Address - Zip Code:76454-3060
Practice Address - Country:US
Practice Address - Phone:254-734-2859
Practice Address - Fax:254-734-2859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-18
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX276913336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy