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NPI Code Detail

MEDICARE: ELIZABETH JANE LOPEZ PHARMD

MEDICARE: ELIZABETH JANE LOPEZ PHARMD
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
1183500000XPharmacist41331TN

General Provider Information

NPI Number : 1689196560
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH JANE LOPEZ PHARMD
Provider Business Mailing Address
First Line : 1616 E MAIN ST
Second Line :
City : HUMBOLDT
State : TN
Zip : 38343-2904
Country : US
Telephone Number : 731-784-3610
Fax Number :
Provider Business Practice Location Address
First Line : 1616 E MAIN ST
Second Line :
City : HUMBOLDT
State : TN
Zip : 38343-2904
Country : US
Telephone Number : 731-784-3610
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2017
Last Update Date : 07/21/2022

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Directions to “ ELIZABETH JANE LOPEZ PHARMD” Practice Location

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