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General NPI Number Information
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NPI Number | 1225705213
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Entity Type | Individual
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Provider Name | ELIZABETH DEAVER CRONAN PHARMD
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Gender | Female
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Dates
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Enumeration Date | 08/26/2021
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Last Update Date | 08/26/2021
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Provider Practice Location Address
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Address Line | 624 SIBLEY AVE
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City | UNION POINT
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State | GA
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Zip | 30669-1140
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Country | US
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Telephone | 706-486-2131
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Fax | 706-486-2132
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Provider Business Mailing Address
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Address Line | PO BOX 1399
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City | COVINGTON
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State | GA
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Zip | 30015-1399
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Country | US
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Telephone | 706-318-1769
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH033066
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License Number State | GA
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