Provider Demographics
NPI:1144389008
Name:LOR, NAOSHUA (PHARM D, RPH)
Entity Type:Individual
Prefix:DR
First Name:NAOSHUA
Middle Name:
Last Name:LOR
Suffix:
Gender:M
Credentials:PHARM D, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1313 PENN AVE N
Mailing Address - Street 2:PHARMACY
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55411-3047
Mailing Address - Country:US
Mailing Address - Phone:612-302-4600
Mailing Address - Fax:612-302-4663
Practice Address - Street 1:1313 PENN AVE N
Practice Address - Street 2:PHARMACY
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55411-3047
Practice Address - Country:US
Practice Address - Phone:612-302-4600
Practice Address - Fax:612-302-4663
Is Sole Proprietor?:No
Enumeration Date:2006-12-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN118469-5183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN118469-5OtherMN BOARD OF PHAMACY LIC.