Lisa E. Gross, PHARM.D.
Individual provider Active NPI Pharmacist · Corry, PA
NPI 1114249406 · NPPES record last updated Feb 27, 2010
Key facts
- NPI
- 1114249406
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- RP437722 (PA)
- Practice address
- 961 E Columbus Ave
Corry, PA 16407-9163 - Phone
- (814) 663-7065
- Fax
- (814) 663-8072
- NPI assigned
- Feb 27, 2010
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RP437722 | PA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RP437722 | PA | Yes |
Addresses
Primary practice location
961 E Columbus Ave
Corry, PA 16407-9163
Mailing address
961 E Columbus Ave
Corry, PA 16407-9163
Phone (814) 663-7065
Other providers in Corry, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 27, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.