Burgoyne, Lori Tewksbury
Burgoyne, Lori Tewksbury is an individual health care provider with primary practice located at 500 N Us Highway 89 , Prescott AZ 86313-5001. She recently has 2 registered licenses in different health care specialties including Pharmacy Service Providers / Pharmacist, Pharmacy Service Providers / Geriatric. Pharmacy Service Providers / Geriatric is her primary health care specialty. Burgoyne, Lori Tewksbury can be contacted via phone (928) 445-4860.Contact Information
Primary practice address
500 N Us Highway 89
Prescott AZ 86313-5001
Phone: (928) 445-4860
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Pharmacy Service Providers / Pharmacist | 183500000X | S007469 | Arizona |
| Pharmacy Service Providers / Geriatric | 1835G0303X | S007469 | Arizona |
Profile Details
| NPI number | 1376842245 |
|---|---|
| LBN Legal business name | Burgoyne, Lori Tewksbury |
| Credentials | RPH, CGP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 18th, 2011 |
| Last updated | Mar 18th, 2011 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1376842245 | NPPES |
| Arizona | Other | S007469 | PHARMACY LICENSE |
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