Elizabeth Anne Bennett, PHARM.D.
Individual provider Active NPI Pharmacist · Madison, MS
NPI 1174936710 · NPPES record last updated Dec 24, 2020
Key facts
- NPI
- 1174936710
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- E-12617 (MS)
- Practice address
- 1014 Highway 51
Madison, MS 39110-8304 - Phone
- (601) 856-2021
- NPI assigned
- Jun 10, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
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 |
|---|---|---|---|
| E-12617 | MS | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mississippi CVS Pharmacy, L.L.C | Past |
Accepting new patients | |
| Mississippi CVS Pharmacy LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | E-12617 | MS | Yes |
Addresses
Primary practice location
1014 Highway 51
Madison, MS 39110-8304
Mailing address
1014 Highway 51
Madison, MS 39110-8304
Phone (601) 856-2021
Other practice location 1
1073 Highway 51
Madison, MS 39110-9085
Phone (601) 605-0402
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| E-12617 | Other | MS | MISSISSIPPI BOARD OF PHARMACY |
Other names
- Betsy Anne Bennett
Other providers in Madison, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 24, 2020. 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.