Provider Demographics
NPI:1306917984
Name:BPHM, LIZZI
Entity type:Individual
Prefix:MS
First Name:LIZZI
Middle Name:
Last Name:BPHM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1072 EVERGREEN DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15235-4656
Mailing Address - Country:US
Mailing Address - Phone:412-537-9304
Mailing Address - Fax:412-244-4749
Practice Address - Street 1:7227 HAMILTON AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15208-1814
Practice Address - Country:US
Practice Address - Phone:412-244-4747
Practice Address - Fax:412-244-4749
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP035770T183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist