Provider Demographics
NPI:1639739881
Name:ALLEN-JOHNSON, EVELYN L (RPH)
Entity Type:Individual
Prefix:
First Name:EVELYN
Middle Name:L
Last Name:ALLEN-JOHNSON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6953 GALL BLVD
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33542-2586
Mailing Address - Country:US
Mailing Address - Phone:813-788-7885
Mailing Address - Fax:813-788-0950
Practice Address - Street 1:6953 GALL BLVD
Practice Address - Street 2:
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33542-2586
Practice Address - Country:US
Practice Address - Phone:813-788-7885
Practice Address - Fax:813-788-0950
Is Sole Proprietor?:No
Enumeration Date:2019-06-19
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS20846183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist