Provider Demographics
NPI:1821406794
Name:EDDY, ELIZABETH (PHARM D)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:EDDY
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:357 S FRENCH CT
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-4262
Mailing Address - Country:US
Mailing Address - Phone:301-283-8818
Mailing Address - Fax:
Practice Address - Street 1:840 S MILITARY HWY
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23464-1824
Practice Address - Country:US
Practice Address - Phone:757-424-2306
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-23
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202213242183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist