Provider Demographics
NPI:1891080578
Name:OLIVER, ELIZABETH MARIE (RPH)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:MARIE
Last Name:OLIVER
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 1:21400 NORTHWESTERN HWY
Mailing Address - Street 2:T0777
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-5006
Mailing Address - Country:US
Mailing Address - Phone:248-663-4300
Mailing Address - Fax:248-663-4300
Practice Address - Street 1:21400 NORTHWESTERN HWY
Practice Address - Street 2:T0777
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-5006
Practice Address - Country:US
Practice Address - Phone:248-663-4300
Practice Address - Fax:248-663-4300
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-10
Last Update Date:2011-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302023620183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist