Provider Demographics
NPI:1184952939
Name:DONALDSON, LONNIE (PHARMACIST)
Entity type:Individual
Prefix:
First Name:LONNIE
Middle Name:
Last Name:DONALDSON
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 S GEORGIA ST
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79109-1904
Mailing Address - Country:US
Mailing Address - Phone:806-468-8616
Mailing Address - Fax:806-468-9859
Practice Address - Street 1:2601 S GEORGIA ST
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79109-1904
Practice Address - Country:US
Practice Address - Phone:806-468-8616
Practice Address - Fax:806-468-9859
Is Sole Proprietor?:No
Enumeration Date:2009-12-04
Last Update Date:2009-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19671183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist