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General NPI Number Information
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NPI Number | 1578187324
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Entity Type | Individual
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Provider Name | ELISA OSLER PHARMD
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Gender | Female
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Dates
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Enumeration Date | 06/07/2020
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Last Update Date | 06/07/2020
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Provider Practice Location Address
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Address Line | 2101 E IRELAND RD
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City | SOUTH BEND
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State | IN
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Zip | 46614-9156
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Country | US
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Telephone | 574-291-1303
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Fax |
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Provider Business Mailing Address
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Address Line | 1514 TALL GRASS PRAIRIE DR
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City | MISHAWAKA
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State | IN
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Zip | 46544-6864
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Country | US
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Telephone | 574-315-8335
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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 | 26026785A
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License Number State | IN
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