Provider Demographics
NPI:1487919080
Name:PRESTON, DONNA R (RPH)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:R
Last Name:PRESTON
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 1:1608 CHAPEL HILL RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-5464
Mailing Address - Country:US
Mailing Address - Phone:573-447-4444
Mailing Address - Fax:573-447-4054
Practice Address - Street 1:1608 CHAPEL HILL RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-5464
Practice Address - Country:US
Practice Address - Phone:573-447-4444
Practice Address - Fax:573-447-4054
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-10
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0424891835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist