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NPI Code Detail

MEDICARE: MS. ELIZABETH L MASON RPH, EMT

MEDICARE: MS. ELIZABETH L MASON RPH, EMT
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
1146N00000XBasic Emergency Medical TechnicianPA095889LPA
2183500000XPharmacistRP034772LPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1RP034772LOTHERPAPHARMACIST LICENSE NUMBER
2PA095889LOTHERPAEMERGENCY MEDICAL TECHNICIAN

General Provider Information

NPI Number : 1649590480
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ELIZABETH L MASON RPH, EMT
Provider Business Mailing Address
First Line : 753 PARKER LN
Second Line :
City : SPRINGFIELD
State : PA
Zip : 19064-1341
Country : US
Telephone Number : 610-604-0974
Fax Number :
Provider Business Practice Location Address
First Line : 510 E BALTIMORE PIKE
Second Line :
City : MEDIA
State : PA
Zip : 19063-3836
Country : US
Telephone Number : 610-566-3218
Fax Number : 610-566-0878
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2010
Last Update Date : 06/03/2010

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