Provider Demographics
NPI:1699893164
Name:MORRELL, LIRIA GUADALUPE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:LIRIA
Middle Name:GUADALUPE
Last Name:MORRELL
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 1:500 4TH AVENUE
Mailing Address - Street 2:
Mailing Address - City:SEWARD
Mailing Address - State:AK
Mailing Address - Zip Code:99664-1808
Mailing Address - Country:US
Mailing Address - Phone:907-224-6003
Mailing Address - Fax:
Practice Address - Street 1:MILE 1.5 SEWARD HWY
Practice Address - Street 2:SAFEWAY PHARMACY
Practice Address - City:SEWARD
Practice Address - State:AK
Practice Address - Zip Code:99664
Practice Address - Country:US
Practice Address - Phone:907-224-6960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2009-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY013415183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY013415OtherPHARMACY LICENSE
AK1831OtherPHARMACY LICENSE