Provider Demographics
NPI:1609407543
Name:LIRONES, DEBRA M (RPH)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:M
Last Name:LIRONES
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1279 ASTRO CT
Mailing Address - Street 2:
Mailing Address - City:JENISON
Mailing Address - State:MI
Mailing Address - Zip Code:49428-9407
Mailing Address - Country:US
Mailing Address - Phone:616-318-5940
Mailing Address - Fax:
Practice Address - Street 1:2375 28TH ST SW
Practice Address - Street 2:
Practice Address - City:WYOMING
Practice Address - State:MI
Practice Address - Zip Code:49519-2380
Practice Address - Country:US
Practice Address - Phone:616-249-7174
Practice Address - Fax:616-249-7185
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-29
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53020258701835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist