Provider Demographics
NPI:1932729563
Name:ELSWICK, KAREN MANEY (RPH)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:MANEY
Last Name:ELSWICK
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 1:1756 ANDERSON HWY
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:VA
Mailing Address - Zip Code:23040-2524
Mailing Address - Country:US
Mailing Address - Phone:804-492-4325
Mailing Address - Fax:
Practice Address - Street 1:1756 ANDERSON HWY
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:VA
Practice Address - Zip Code:23040-2524
Practice Address - Country:US
Practice Address - Phone:804-467-2992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-23
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA02020071713336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0202007171OtherSTATE OF VIRGINIA