Elizabeth McCormick, PHARMD – Pharmacist

Key facts

NPI: 1104133347
Entity type: Individual (NPI type 1)
Primary specialty: Pharmacist 183500000X
License: 18831 (LA)
Practice address: 510 Kings Hwy
Shreveport, LA 71104-4444
Phone: (318) 424-0896
NPI assigned: Sep 9, 2010
Sex: Female
Sole proprietor: No

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No
Credentials: Doctor of Pharmacy

State licenses

License	State	Type	Specialty
18831	LA	MD	Pharmacist

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Pharmacist	183500000X	18831	LA	Yes

Addresses

Primary practice location

510 Kings Hwy
Shreveport, LA 71104-4444

Mailing address

510 Kings Hwy
Shreveport, LA 71104-4444
Phone (318) 424-0896

Other identifiers

Identifier	Type	State	Issuer
1896667	Medicaid	LA

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 9, 2010.

{
    "created_epoch": "1283990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283990400000",
    "number": "1104133347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 KINGS HWY",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711044444",
            "telephone_number": "318-424-0896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 KINGS HWY",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711044444",
            "telephone_number": "318-424-0896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORMICK",
        "first_name": "ELIZABETH",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-09",
        "last_updated": "2010-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "LA",
            "license": "18831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1896667",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Bradly Scott McCollum, LCSW
Natalie McConnell, MD
Stephanie McConnell, M.A.
Bruce K McCormick, PHD
Carla McCormick
Greta Anita McCormick, MSN, APRN, PMHNP-BC
Ashley Nicole McCoy
Barbara W McCoy, MIDWIFE, WHNP
Robert N McCoy, MD
Tenetia Andrea McCoy

All providers in Shreveport, LA · Pharmacist in Louisiana

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 9, 2010. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.