Provider Demographics
NPI:1669996500
Name:ELSWICK, SARAH MAHALIA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:MAHALIA
Last Name:ELSWICK
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 1:338 KENTUCKY AVE SE
Mailing Address - Street 2:
Mailing Address - City:NORTON
Mailing Address - State:VA
Mailing Address - Zip Code:24273-2706
Mailing Address - Country:US
Mailing Address - Phone:276-345-2984
Mailing Address - Fax:
Practice Address - Street 1:911 BYPASS RD
Practice Address - Street 2:BLDG E, STE 1
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501
Practice Address - Country:US
Practice Address - Phone:606-218-3576
Practice Address - Fax:276-218-3961
Is Sole Proprietor?:No
Enumeration Date:2017-08-02
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY019419183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY019419OtherPHARMACIST LICENSE