Provider Demographics
NPI:1235720897
Name:LOTA, DONNA (PHARM D)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:LOTA
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2040 GRABALL RD
Mailing Address - Street 2:
Mailing Address - City:TIGNALL
Mailing Address - State:GA
Mailing Address - Zip Code:30668-4404
Mailing Address - Country:US
Mailing Address - Phone:706-401-0539
Mailing Address - Fax:
Practice Address - Street 1:21 N CAROLINA ST
Practice Address - Street 2:
Practice Address - City:HARTWELL
Practice Address - State:GA
Practice Address - Zip Code:30643-7206
Practice Address - Country:US
Practice Address - Phone:706-376-3147
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-27
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH0271583336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy