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General NPI Number Information
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NPI Number | 1942389366
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Entity Type | Individual
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Provider Name | ELIZABETH C CANNON RPH
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Gender | Female
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Dates
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Enumeration Date | 11/05/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 201 MAIN ST W
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City | ABBEVILLE
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State | GA
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Zip | 31001-4211
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Country | US
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Telephone | 229-467-2221
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Fax | 229-467-2089
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Provider Business Mailing Address
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Address Line | 112 4TH ST P.O. BOX 340
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City | RHINE
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State | GA
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Zip | 31077-4139
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Country | US
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Telephone | 229-385-6914
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Fax | 229-467-2089
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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 | 011583
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License Number State | GA
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