Provider Demographics
NPI:1417447780
Name:STORCH, DENNIS JOE (RPH)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:JOE
Last Name:STORCH
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4425 19TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79407-2408
Mailing Address - Country:US
Mailing Address - Phone:806-788-2015
Mailing Address - Fax:806-788-2016
Practice Address - Street 1:4425 19TH ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79407-2408
Practice Address - Country:US
Practice Address - Phone:806-788-2015
Practice Address - Fax:806-788-2016
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-12
Last Update Date:2018-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX249121835P0018X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist