Provider Demographics
NPI:1588269088
Name:ALLEN, ELIZABETH GRACE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:GRACE
Last Name:ALLEN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 POST OFFICE SQ
Mailing Address - Street 2:
Mailing Address - City:HARWICH PORT
Mailing Address - State:MA
Mailing Address - Zip Code:02646-1883
Mailing Address - Country:US
Mailing Address - Phone:508-430-0660
Mailing Address - Fax:508-430-8110
Practice Address - Street 1:MAIN ST, 6 POST OFFICE SQ
Practice Address - Street 2:
Practice Address - City:HARWICH PORT
Practice Address - State:MA
Practice Address - Zip Code:02646-1883
Practice Address - Country:US
Practice Address - Phone:508-430-0660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-02
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH239796183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist