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General NPI Number Information
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NPI Number | 1720655509
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Entity Type | Individual
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Provider Name | ELISE KING
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Gender | Female
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Dates
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Enumeration Date | 06/09/2021
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Last Update Date | 01/30/2025
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Provider Practice Location Address
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Address Line | 922 SENATE DR
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City | DAYTON
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State | OH
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Zip | 45459-4017
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Country | US
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Telephone | 937-610-3051
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Fax | 937-610-3048
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Provider Business Mailing Address
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Address Line | 922 SENATE DR
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City | DAYTON
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State | OH
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Zip | 45459-4017
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Country | US
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Telephone | 937-610-3051
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Fax | 937-610-3048
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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 | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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