Provider Demographics
NPI:1063035103
Name:LUSK, ELIZABETH H (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:H
Last Name:LUSK
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3705 FLINT POINTE CIR SW
Mailing Address - Street 2:
Mailing Address - City:HARTSELLE
Mailing Address - State:AL
Mailing Address - Zip Code:35640-6035
Mailing Address - Country:US
Mailing Address - Phone:256-654-7327
Mailing Address - Fax:
Practice Address - Street 1:241 HIGHWAY 31 SW STE 60
Practice Address - Street 2:
Practice Address - City:HARTSELLE
Practice Address - State:AL
Practice Address - Zip Code:35640-2855
Practice Address - Country:US
Practice Address - Phone:256-751-2102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-23
Last Update Date:2020-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL168341835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist