Provider Demographics
NPI:1720234149
Name:ELLIOTT, AMIE R (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:AMIE
Middle Name:R
Last Name:ELLIOTT
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:826 PENINSULA ACRES
Mailing Address - Street 2:
Mailing Address - City:BATH
Mailing Address - State:NC
Mailing Address - Zip Code:27808-9314
Mailing Address - Country:US
Mailing Address - Phone:252-944-5244
Mailing Address - Fax:
Practice Address - Street 1:418 US HIGHWAY 264 BYP
Practice Address - Street 2:
Practice Address - City:BELHAVEN
Practice Address - State:NC
Practice Address - Zip Code:27810-9291
Practice Address - Country:US
Practice Address - Phone:252-943-6260
Practice Address - Fax:252-944-0095
Is Sole Proprietor?:No
Enumeration Date:2008-08-18
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16813183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist