Individual
ELIZABETH MCCORMICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
510 KINGS HWY, SHREVEPORT, LA 71104-4444
(318) 424-0896
Mailing address
510 KINGS HWY, SHREVEPORT, LA 71104-4444
(318) 424-0896
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
18831
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1896667
—
LA
Enumeration date
09/09/2010
Last updated
09/09/2010
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