Provider Demographics
NPI:1295042745
Name:BUTLER, ELIZABETH PRICE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:PRICE
Last Name:BUTLER
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 1:3450 HIGHWAY 190
Mailing Address - Street 2:
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70471-3196
Mailing Address - Country:US
Mailing Address - Phone:985-626-0481
Mailing Address - Fax:
Practice Address - Street 1:3450 HIGHWAY 190
Practice Address - Street 2:
Practice Address - City:MANDEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70471-3196
Practice Address - Country:US
Practice Address - Phone:985-626-0481
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-04
Last Update Date:2010-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA18836183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist