Healthcare Provider Details

I. General information

NPI: 1932542651
Provider Name (Legal Business Name): ELIZABETH TESCH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2013
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

86 MDG RAMSTEIN, DEPARTMENT OF THE AIR FORCE 86 MDG OPC 02 BOX 60
APO AE
09094-9001
US

IV. Provider business mailing address

300 TWINING ST BLDG 760
MAXWELL AFB AL
36112-6027
US

V. Phone/Fax

Practice location:
  • Phone: 314-479-2609
  • Fax:
Mailing address:
  • Phone: 334-953-5200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberPS52880
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License NumberPS52880
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code1835C0206X
TaxonomyCardiology Pharmacist
License NumberPS52880
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: