Provider Demographics
NPI:1891373940
Name:BENJAMIN, ELIZABETH SCHLEICH (RPH)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:SCHLEICH
Last Name:BENJAMIN
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 1:448 TUSCANY CT
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81507-4515
Mailing Address - Country:US
Mailing Address - Phone:970-261-7449
Mailing Address - Fax:
Practice Address - Street 1:707 ELBERTA AVE UNIT B
Practice Address - Street 2:
Practice Address - City:PALISADE
Practice Address - State:CO
Practice Address - Zip Code:81526-8806
Practice Address - Country:US
Practice Address - Phone:970-464-5668
Practice Address - Fax:970-464-5664
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-31
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO14229183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist