Provider Demographics
NPI:1265920706
Name:MOREY, DONNA MICHELLE (PHARMACIST)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:MICHELLE
Last Name:MOREY
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1212 S MADISON ST
Mailing Address - Street 2:
Mailing Address - City:WEBB CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64870-2834
Mailing Address - Country:US
Mailing Address - Phone:417-673-5623
Mailing Address - Fax:417-673-5409
Practice Address - Street 1:1212 S MADISON ST
Practice Address - Street 2:
Practice Address - City:WEBB CITY
Practice Address - State:MO
Practice Address - Zip Code:64870-2834
Practice Address - Country:US
Practice Address - Phone:417-673-5623
Practice Address - Fax:417-673-5409
Is Sole Proprietor?:No
Enumeration Date:2018-04-30
Last Update Date:2018-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001027002183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist