Provider Demographics
NPI:1033422589
Name:ENG-LIU, EILEEN
Entity Type:Individual
Prefix:MRS
First Name:EILEEN
Middle Name:
Last Name:ENG-LIU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 MAGELLAN PLAZA
Mailing Address - Street 2:
Mailing Address - City:MARYLAND HTS
Mailing Address - State:MO
Mailing Address - Zip Code:63043-4421
Mailing Address - Country:US
Mailing Address - Phone:800-450-7281
Mailing Address - Fax:
Practice Address - Street 1:14100 MAGELLAN PLZ
Practice Address - Street 2:
Practice Address - City:MARYLAND HEIGHTS
Practice Address - State:MO
Practice Address - Zip Code:63043-4644
Practice Address - Country:US
Practice Address - Phone:800-450-7281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-26
Last Update Date:2010-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY043456183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist