Provider Demographics
NPI:1598073918
Name:RILEY, LORI MICHELLE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:LORI
Middle Name:MICHELLE
Last Name:RILEY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1310 W MORTON ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND CITY
Mailing Address - State:IN
Mailing Address - Zip Code:47660-7615
Mailing Address - Country:US
Mailing Address - Phone:812-749-4129
Mailing Address - Fax:812-749-4561
Practice Address - Street 1:1310 W MORTON ST
Practice Address - Street 2:
Practice Address - City:OAKLAND CITY
Practice Address - State:IN
Practice Address - Zip Code:47660-7615
Practice Address - Country:US
Practice Address - Phone:812-749-4129
Practice Address - Fax:812-749-4561
Is Sole Proprietor?:No
Enumeration Date:2010-09-20
Last Update Date:2010-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26019270A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist