Provider Demographics
NPI:1801212931
Name:DEAL, ELIZABETH (CPHT)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:DEAL
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 SPARTANBURG HWY
Mailing Address - Street 2:
Mailing Address - City:LYMAN
Mailing Address - State:SC
Mailing Address - Zip Code:29365-1808
Mailing Address - Country:US
Mailing Address - Phone:864-439-6127
Mailing Address - Fax:864-439-9753
Practice Address - Street 1:204 SPARTANBURG HWY
Practice Address - Street 2:
Practice Address - City:LYMAN
Practice Address - State:SC
Practice Address - Zip Code:29365-1808
Practice Address - Country:US
Practice Address - Phone:864-439-6127
Practice Address - Fax:864-439-9753
Is Sole Proprietor?:No
Enumeration Date:2014-03-13
Last Update Date:2014-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC12160183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician