Provider Demographics
NPI:1194151548
Name:MARCINKO, ELIZABETH F (RPH)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:F
Last Name:MARCINKO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8455 DALEPOINT RD.
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:OH
Mailing Address - Zip Code:44131
Mailing Address - Country:US
Mailing Address - Phone:216-328-0656
Mailing Address - Fax:
Practice Address - Street 1:6801 BRECKSVILLE RD
Practice Address - Street 2:SUITE 10
Practice Address - City:INDEPENDENCE
Practice Address - State:OH
Practice Address - Zip Code:44131
Practice Address - Country:US
Practice Address - Phone:216-636-8700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-17
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03319839183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist