Provider Demographics
NPI:1386952836
Name:GLOVER, LORI MICHELLE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:LORI
Middle Name:MICHELLE
Last Name:GLOVER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:LORI
Other - Middle Name:BJORK
Other - Last Name:GLOVER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:650 E INDIAN SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-1839
Mailing Address - Country:US
Mailing Address - Phone:480-397-2894
Mailing Address - Fax:
Practice Address - Street 1:650 E INDIAN SCHOOL RD
Practice Address - Street 2:PHOENIX VA HEALTHCARE SYSTEM
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-1839
Practice Address - Country:US
Practice Address - Phone:602-277-5551
Practice Address - Fax:602-222-2679
Is Sole Proprietor?:No
Enumeration Date:2010-09-17
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47582183500000X
AZ10060183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist