Provider Demographics
NPI:1063742310
Name:CAUM, LORRI KRISTEN (RPH)
Entity type:Individual
Prefix:MS
First Name:LORRI
Middle Name:KRISTEN
Last Name:CAUM
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2075 W PINNACLE PEAK RD STE 130
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85027-1218
Mailing Address - Country:US
Mailing Address - Phone:602-214-6618
Mailing Address - Fax:623-215-0423
Practice Address - Street 1:2075 W PINNACLE PEAK RD STE 130
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-1218
Practice Address - Country:US
Practice Address - Phone:602-214-6618
Practice Address - Fax:623-215-0423
Is Sole Proprietor?:No
Enumeration Date:2010-01-09
Last Update Date:2010-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS12685183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist