Provider Demographics
NPI:1992037907
Name:LOVEJOY, DONNA J
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:J
Last Name:LOVEJOY
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 1:13340 W VIA CABALLO BLANCO
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85383-7920
Mailing Address - Country:US
Mailing Address - Phone:928-252-3343
Mailing Address - Fax:
Practice Address - Street 1:28516 N EL MIRAGE RD
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85383-2094
Practice Address - Country:US
Practice Address - Phone:623-215-8107
Practice Address - Fax:623-215-7412
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-02
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS017317183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist