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Individual

DR. ALICIA BEATRIX ELAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHARM.D.

Contact information

Practice address
3650 WHEELER RD, AUGUSTA, GA 30909-6520
(706) 210-7991
Mailing address
2930 MAYFAIR RD, AUGUSTA, GA 30909-3569
(706) 394-2187
(706) 955-9773

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
12058
SC
183500000X
Pharmacist
Primary
RPH018336
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
12058
SC PHARMACY LICENSE
SC
01
RPH018336
PHARMACY LICENSE
GA
Enumeration date
03/09/2011
Last updated
03/09/2011
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