Healthcare Provider Details

I. General information

NPI: 1962782409
Provider Name (Legal Business Name): ELIZABETH L ALFORD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2011
Last Update Date: 08/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3113 ROGERS RD SUITE 100
WAKE FOREST NC
27587-3803
US

IV. Provider business mailing address

1927 HIGH HOLLY LN
RALEIGH NC
27614-7796
US

V. Phone/Fax

Practice location:
  • Phone: 919-554-2699
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: