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NPI Code Detail

MEDICARE: KENZA ELLIOTT RPH

MEDICARE: KENZA ELLIOTT RPH
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
1183500000XPharmacistA1-0004788DE

General Provider Information

NPI Number : 1386020881
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENZA ELLIOTT RPH
Provider Business Mailing Address
First Line : 2480 S DUPONT HWY
Second Line :
City : CAMDEN
State : DE
Zip : 19934-1226
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2480 S DUPONT HWY
Second Line :
City : CAMDEN
State : DE
Zip : 19934-1226
Country : US
Telephone Number : 302-698-6404
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/06/2015
Last Update Date : 08/06/2015

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Directions to “ KENZA ELLIOTT RPH” Practice Location

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