Provider Demographics
NPI:1942800347
Name:LAMOTHE, COURTNEY ANNE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:COURTNEY
Middle Name:ANNE
Last Name:LAMOTHE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:ANNE
Other - Last Name:MORGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:110 MERRYWOOD DR
Mailing Address - Street 2:
Mailing Address - City:FOREST
Mailing Address - State:VA
Mailing Address - Zip Code:24551-1106
Mailing Address - Country:US
Mailing Address - Phone:434-525-4064
Mailing Address - Fax:
Practice Address - Street 1:22088 TIMBERLAKE RD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-7406
Practice Address - Country:US
Practice Address - Phone:434-439-3140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0008213183500000X
VA0202212295183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist