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General NPI Number Information
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NPI Number | 1437745593
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Entity Type | Individual
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Provider Name | ELAINA NICOLE GARVONIC PHARMD
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Gender | Female
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Dates
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Enumeration Date | 12/14/2020
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Last Update Date | 12/14/2020
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Provider Practice Location Address
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Address Line | 5990 SASHABAW RD
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City | CLARKSTON
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State | MI
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Zip | 48346-3154
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Country | US
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Telephone | 248-922-3704
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Fax |
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Provider Business Mailing Address
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Address Line | 46830 GADWALL DR
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City | MACOMB
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State | MI
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Zip | 48044-3209
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Country | US
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Telephone | 865-738-7688
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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 | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 5315221771
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 5302413085
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License Number State | MI
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