Provider Demographics
NPI:1023347267
Name:LAWRENCE, EILEEN F (RPH)
Entity type:Individual
Prefix:MS
First Name:EILEEN
Middle Name:F
Last Name:LAWRENCE
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 1:1422 E HIDDEN RANCH LOOP
Mailing Address - Street 2:
Mailing Address - City:PALMER
Mailing Address - State:AK
Mailing Address - Zip Code:99645-8336
Mailing Address - Country:US
Mailing Address - Phone:907-745-6522
Mailing Address - Fax:
Practice Address - Street 1:1422 E HIDDEN RANCH LOOP
Practice Address - Street 2:
Practice Address - City:PALMER
Practice Address - State:AK
Practice Address - Zip Code:99645-8336
Practice Address - Country:US
Practice Address - Phone:907-745-6522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-17
Last Update Date:2009-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO16708183500000X
AK1158183500000X
FLPS23705183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist