Provider Demographics
NPI:1245992940
Name:PORR, WILLIAM (RPH)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:PORR
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 1:10 W BROADWAY
Mailing Address - Street 2:
Mailing Address - City:RED LION
Mailing Address - State:PA
Mailing Address - Zip Code:17356-2195
Mailing Address - Country:US
Mailing Address - Phone:717-244-4450
Mailing Address - Fax:
Practice Address - Street 1:10 W BROADWAY
Practice Address - Street 2:
Practice Address - City:RED LION
Practice Address - State:PA
Practice Address - Zip Code:17356-2195
Practice Address - Country:US
Practice Address - Phone:717-244-4450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-10
Last Update Date:2021-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP033105L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist