Provider Demographics
NPI:1194247478
Name:EUBANKS, ELIZABETH ROGERS (PHARMD)
Entity type:Individual
Prefix:MISS
First Name:ELIZABETH
Middle Name:ROGERS
Last Name:EUBANKS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:CLARE
Other - Last Name:ROGERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:1016 OLD BIRCH DR
Mailing Address - Street 2:
Mailing Address - City:BLYTHEWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29016-9778
Mailing Address - Country:US
Mailing Address - Phone:803-673-6354
Mailing Address - Fax:
Practice Address - Street 1:2400 PRATT ST STE 5000
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-3976
Practice Address - Country:US
Practice Address - Phone:919-668-1018
Practice Address - Fax:919-613-2422
Is Sole Proprietor?:No
Enumeration Date:2017-07-08
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC37126183500000X
NC270031835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology
No183500000XPharmacy Service ProvidersPharmacist