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General NPI Number Information
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NPI Number | 1700347572
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Entity Type | Individual
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Provider Name | ELISABETH ANN ALDRIDGE RPH
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Gender | Female
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Dates
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Enumeration Date | 03/26/2019
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 124 MAIN ST
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City | MAN
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State | WV
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Zip | 25635-1212
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Country | US
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Telephone | 304-583-9910
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Fax | 304-583-9929
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Provider Business Mailing Address
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Address Line | 237 GENTLE BREEZE DR
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City | CHAPMANVILLE
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State | WV
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Zip | 25508-5809
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Country | US
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Telephone | 304-752-2353
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Fax | 304-583-9929
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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 | RP0006331
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License Number State | WV
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