Healthcare Provider Details

I. General information

NPI: 1841203155
Provider Name (Legal Business Name): ELIZABETH NELSON PLOTT R.PH.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1161 HIGHWAY 72
KILLEN AL
35645
US

IV. Provider business mailing address

217 W QUEENSBURY LN
FLORENCE AL
35630-6627
US

V. Phone/Fax

Practice location:
  • Phone: 256-757-1161
  • Fax: 256-757-1132
Mailing address:
  • Phone: 256-766-0504
  • Fax: 256-764-6092

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number9164
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: