MEDICARE: MRS. KAREN MANEY ELSWICK 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
1	3336C0003X	Community/Retail Pharmacy	0202007171	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0202007171	OTHER	VA	STATE OF VIRGINIA

General Provider Information

NPI Number	:	1932729563
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KAREN MANEY ELSWICK RPH

Provider Business Mailing Address
First Line	:	1756 ANDERSON HWY
Second Line	:
City	:	CUMBERLAND
State	:	VA
Zip	:	23040-2524
Country	:	US
Telephone Number	:	804-492-4325
Fax Number	:

Provider Business Practice Location Address
First Line	:	1756 ANDERSON HWY
Second Line	:
City	:	CUMBERLAND
State	:	VA
Zip	:	23040-2524
Country	:	US
Telephone Number	:	804-467-2992
Fax Number	:

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

Provider Enumeration Date	:	04/23/2020
Last Update Date	:	04/23/2020

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