Provider Demographics
NPI:1972667988
Name:WHEATON, ELIZABETH S (RPH)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:S
Last Name:WHEATON
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 1:5 PLUMLEIGH DR
Mailing Address - Street 2:
Mailing Address - City:DARTMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02747-1337
Mailing Address - Country:US
Mailing Address - Phone:508-998-7569
Mailing Address - Fax:
Practice Address - Street 1:43 HIGH ST
Practice Address - Street 2:TOBEY HOSPITAL
Practice Address - City:WAREHAM
Practice Address - State:MA
Practice Address - Zip Code:02571-2097
Practice Address - Country:US
Practice Address - Phone:508-273-4250
Practice Address - Fax:508-273-4252
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA20598183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist