Provider Demographics
NPI:1609664481
Name:LONGO, ELIZABETH SARA (PHARMACY STUDENT)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:SARA
Last Name:LONGO
Suffix:
Gender:
Credentials:PHARMACY STUDENT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6000 SHEPHERD MOUNTAIN CV UNIT 517
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78730-4902
Mailing Address - Country:US
Mailing Address - Phone:361-737-1905
Mailing Address - Fax:
Practice Address - Street 1:6000 SHEPHERD MOUNTAIN CV UNIT 517
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78730-4902
Practice Address - Country:US
Practice Address - Phone:361-737-1905
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-30
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician