Provider Demographics
NPI:1578164521
Name:ORACH, LORI ANN
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:ANN
Last Name:ORACH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:TUSCARORA
Mailing Address - State:PA
Mailing Address - Zip Code:17982-2400
Mailing Address - Country:US
Mailing Address - Phone:570-225-1204
Mailing Address - Fax:
Practice Address - Street 1:500 TERRY RICH BLVD
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR
Practice Address - State:PA
Practice Address - Zip Code:17970-1090
Practice Address - Country:US
Practice Address - Phone:570-429-2004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-05
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP037691L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist