Provider Demographics
NPI:1174969620
Name:FERGUSON MININNI, DONNA G (RPH)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:G
Last Name:FERGUSON MININNI
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 1:331 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-2705
Mailing Address - Country:US
Mailing Address - Phone:831-424-8053
Mailing Address - Fax:831-424-4707
Practice Address - Street 1:331 MAIN ST
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-2705
Practice Address - Country:US
Practice Address - Phone:831-424-8053
Practice Address - Fax:831-424-4707
Is Sole Proprietor?:No
Enumeration Date:2013-05-10
Last Update Date:2013-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38537183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist