MEDICARE: ELIZABETH ELLEN ASHCRAFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	7599	SC

General Provider Information

NPI Number	:	1043204209
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH ELLEN ASHCRAFT

Provider Business Mailing Address
First Line	:	1320 CROWN REACH
Second Line	:
City	:	MOUNT PLEASANT
State	:	SC
Zip	:	29466-7921
Country	:	US
Telephone Number	:	843-881-5745
Fax Number	:

Provider Business Practice Location Address
First Line	:	135 RUTLEDGE ST
Second Line	:	ROOM 911
City	:	CHARLESTON
State	:	SC
Zip	:	29425-8903
Country	:	US
Telephone Number	:	843-876-1390
Fax Number	:	843-876-0678

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/02/2005
Last Update Date	:	07/08/2007

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