Provider Demographics
NPI:1023116381
Name:SCOGIN, ELIZABETH ANN (RPH)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:ANN
Last Name:SCOGIN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MRS
Other - First Name:BETSY
Other - Middle Name:
Other - Last Name:SCOGIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:924 BEAVER LAKE DR
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75501-0980
Mailing Address - Country:US
Mailing Address - Phone:903-832-6987
Mailing Address - Fax:
Practice Address - Street 1:5001 N STATE LINE AVE STE C
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-2962
Practice Address - Country:US
Practice Address - Phone:180-078-5913
Practice Address - Fax:190-373-5401
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX25851183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist