Provider Demographics
NPI:1932100419
Name:BANKS, ELIZABETH F (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:F
Last Name:BANKS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2008 GASLIGHT DR
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95355-8104
Mailing Address - Country:US
Mailing Address - Phone:209-551-3419
Mailing Address - Fax:
Practice Address - Street 1:2008 GASLIGHT DR
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355-8104
Practice Address - Country:US
Practice Address - Phone:209-551-3419
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA55672183500000X, 1835N1003X, 1835P1200X
LA17059183500000X, 1835N1003X, 1835P1200X
FL34457183500000X, 1835N1003X, 1835P1200X
SC010005183500000X, 1835N1003X, 1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered183500000XPharmacy Service ProvidersPharmacist
Not Answered1835N1003XPharmacy Service ProvidersPharmacistNutrition Support
Not Answered1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy