Provider Demographics
NPI:1730320516
Name:LEVENSON, LOUIS ELLIOTT (RPH)
Entity Type:Individual
Prefix:MR
First Name:LOUIS
Middle Name:ELLIOTT
Last Name:LEVENSON
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 FAIRWAY ST
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19963-3773
Mailing Address - Country:US
Mailing Address - Phone:302-430-5440
Mailing Address - Fax:
Practice Address - Street 1:640 S STATE ST
Practice Address - Street 2:BAYHEALTH MEDICAL CENTER DEPARTMENT OF PHARMACY SVCS
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19901-3530
Practice Address - Country:US
Practice Address - Phone:302-744-6921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-09
Last Update Date:2009-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA1-0003375183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist