Provider Demographics
NPI:1992961981
Name:GUNN, LORRAINE ESTELLE (RPH)
Entity type:Individual
Prefix:MS
First Name:LORRAINE
Middle Name:ESTELLE
Last Name:GUNN
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 1:3725 RIVERS AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:N CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29405-7072
Mailing Address - Country:US
Mailing Address - Phone:843-745-8650
Mailing Address - Fax:843-554-5453
Practice Address - Street 1:3725 RIVERS AVE STE 2
Practice Address - Street 2:
Practice Address - City:N CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29405-7072
Practice Address - Country:US
Practice Address - Phone:843-745-8650
Practice Address - Fax:843-554-5453
Is Sole Proprietor?:No
Enumeration Date:2008-07-30
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7187183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist