Provider Demographics
NPI:1427328541
Name:OLIVER, ELIZABETH ERIN (RPH)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ERIN
Last Name:OLIVER
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 1:759 JEFFERSON PL
Mailing Address - Street 2:
Mailing Address - City:TAYLOR MILL
Mailing Address - State:KY
Mailing Address - Zip Code:41015-2233
Mailing Address - Country:US
Mailing Address - Phone:859-356-4893
Mailing Address - Fax:
Practice Address - Street 1:160 PAVILION PKWY
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:KY
Practice Address - Zip Code:41071-2884
Practice Address - Country:US
Practice Address - Phone:859-814-0141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-05
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY012406183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist