Provider Demographics
NPI:1689909079
Name:PERRIN, DONALD GUY (RPH)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:GUY
Last Name:PERRIN
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 1:11 N BROADWAY
Mailing Address - Street 2:P.O. BOX 621
Mailing Address - City:PELICAN RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:56572-4138
Mailing Address - Country:US
Mailing Address - Phone:218-863-1441
Mailing Address - Fax:218-863-1558
Practice Address - Street 1:11 N BROADWAY
Practice Address - Street 2:
Practice Address - City:PELICAN RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:56572-4138
Practice Address - Country:US
Practice Address - Phone:218-863-1441
Practice Address - Fax:218-863-1558
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-02
Last Update Date:2009-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN112381183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist