Provider Demographics
NPI:1003461989
Name:GILBERT, ELIZABETH (PHARMD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:GILBERT
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 1:8863 PUMP STATION RD
Mailing Address - Street 2:
Mailing Address - City:POLAND
Mailing Address - State:IN
Mailing Address - Zip Code:47868-6826
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:307 E NATIONAL AVE
Practice Address - Street 2:
Practice Address - City:BRAZIL
Practice Address - State:IN
Practice Address - Zip Code:47834-2629
Practice Address - Country:US
Practice Address - Phone:812-446-2301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-07
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26023553A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist