Provider Demographics
NPI:1518124270
Name:MCCORMICK, ELIZABETH SHAE (PHARM D)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:SHAE
Last Name:MCCORMICK
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 1:8609 W MARKHAM ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-2312
Mailing Address - Country:US
Mailing Address - Phone:501-225-2222
Mailing Address - Fax:501-225-8683
Practice Address - Street 1:8609 W MARKHAM ST
Practice Address - Street 2:SUITE A
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-2312
Practice Address - Country:US
Practice Address - Phone:501-225-2222
Practice Address - Fax:501-225-8683
Is Sole Proprietor?:No
Enumeration Date:2008-05-20
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR9506183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist