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NPI Code Detail

MEDICARE: WILLIAM RUDOLPH ELLIOTT RPH

MEDICARE: WILLIAM RUDOLPH 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
1183500000XPharmacistPS19392FL
21835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistPS19392FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1831438795
Entity Type Code : Individual
Provider Name (Legal Business Name) : WILLIAM RUDOLPH ELLIOTT RPH
Provider Business Mailing Address
First Line : 6331 EASTWOOD LN
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32211-3918
Country : US
Telephone Number : 904-314-4022
Fax Number :
Provider Business Practice Location Address
First Line : 6331 EASTWOOD LN
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32211-3918
Country : US
Telephone Number : 904-314-4022
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/12/2013
Last Update Date : 03/18/2021

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