Provider Demographics
NPI:1518256072
Name:ENDICOTT, ELIZABETH ASHLEY (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:ASHLEY
Last Name:ENDICOTT
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 1:9145 BEAUTY ROAD
Mailing Address - Street 2:
Mailing Address - City:WARFIELD
Mailing Address - State:KY
Mailing Address - Zip Code:41267-9145
Mailing Address - Country:US
Mailing Address - Phone:606-395-0522
Mailing Address - Fax:606-395-5480
Practice Address - Street 1:9145 BEAUTY RD
Practice Address - Street 2:
Practice Address - City:WARFIELD
Practice Address - State:KY
Practice Address - Zip Code:41267-9145
Practice Address - Country:US
Practice Address - Phone:606-395-0522
Practice Address - Fax:606-395-5480
Is Sole Proprietor?:No
Enumeration Date:2011-04-05
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY014207183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist