Provider Demographics
NPI:1649557729
Name:PARKER, ELIZABETH ANN (RPH)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:ANN
Last Name:PARKER
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 1:110 ELIZABETH ST
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25311-2117
Mailing Address - Country:US
Mailing Address - Phone:304-552-5947
Mailing Address - Fax:
Practice Address - Street 1:20442 CHARLESTON RD
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:WV
Practice Address - Zip Code:25033
Practice Address - Country:US
Practice Address - Phone:304-937-3000
Practice Address - Fax:304-934-4141
Is Sole Proprietor?:No
Enumeration Date:2011-11-03
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV5429183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist