Healthcare Provider Details

I. General information

NPI: 1356865935
Provider Name (Legal Business Name): ELIZABETH ANNE PRICE PHARMD, MSCR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2017
Last Update Date: 07/26/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9249 HWY 29 ATHENS COMMUNITY BASED OUTPATIENT VA CLINIC
ATHENS GA
30601
US

IV. Provider business mailing address

250 W GREEN ST RM 260-J
ATHENS GA
30602-2354
US

V. Phone/Fax

Practice location:
  • Phone: 706-227-4534
  • Fax:
Mailing address:
  • Phone: 706-542-5111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number26175
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: