Provider Demographics
NPI:1417224080
Name:LORENZO, DAVID RONALD (RPH)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:RONALD
Last Name:LORENZO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:731 FAIRHURST ST
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:CO
Mailing Address - Zip Code:80751-4525
Mailing Address - Country:US
Mailing Address - Phone:970-522-2930
Mailing Address - Fax:
Practice Address - Street 1:731 FAIRHURST ST
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:CO
Practice Address - Zip Code:80751-4525
Practice Address - Country:US
Practice Address - Phone:970-522-2930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-25
Last Update Date:2011-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO14227183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist