Provider Demographics
NPI:1679132120
Name:GORTON, TRICIA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:TRICIA
Middle Name:
Last Name:GORTON
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 1:602 STEWART RD
Mailing Address - Street 2:
Mailing Address - City:COLLEGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19426-1750
Mailing Address - Country:US
Mailing Address - Phone:484-636-8840
Mailing Address - Fax:
Practice Address - Street 1:929 DEKALB PIKE
Practice Address - Street 2:
Practice Address - City:BLUE BELL
Practice Address - State:PA
Practice Address - Zip Code:19422-1809
Practice Address - Country:US
Practice Address - Phone:610-292-2142
Practice Address - Fax:610-292-4612
Is Sole Proprietor?:No
Enumeration Date:2019-06-09
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP448766183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist