Provider Demographics
NPI:1740338987
Name:BRIDGES, ELIZABETH ANNE (RPH)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:ANNE
Last Name:BRIDGES
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 COUNTRY LN
Mailing Address - Street 2:
Mailing Address - City:EATONTON
Mailing Address - State:GA
Mailing Address - Zip Code:31024-6050
Mailing Address - Country:US
Mailing Address - Phone:404-307-0603
Mailing Address - Fax:706-485-2122
Practice Address - Street 1:303 S JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:EATONTON
Practice Address - State:GA
Practice Address - Zip Code:31024-1129
Practice Address - Country:US
Practice Address - Phone:404-307-0603
Practice Address - Fax:706-485-2122
Is Sole Proprietor?:No
Enumeration Date:2007-01-06
Last Update Date:2009-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH016182183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist