Provider Demographics
NPI:1902855208
Name:MILLSAPS, ELIZABETH MORGAN (RPH, PHARM D)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:MORGAN
Last Name:MILLSAPS
Suffix:
Gender:F
Credentials:RPH, PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 S SCOTT ST
Mailing Address - Street 2:
Mailing Address - City:CAMILLA
Mailing Address - State:GA
Mailing Address - Zip Code:31730-1716
Mailing Address - Country:US
Mailing Address - Phone:229-336-7758
Mailing Address - Fax:229-336-5615
Practice Address - Street 1:159 E BROAD ST
Practice Address - Street 2:
Practice Address - City:CAMILLA
Practice Address - State:GA
Practice Address - Zip Code:31730-1842
Practice Address - Country:US
Practice Address - Phone:229-336-7758
Practice Address - Fax:229-336-5615
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA021772183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1146364OtherNABP- OPTIONCARE
GA1107223OtherNABP- THRIFT CENTER PHARM