Elizabeth Ann Gordon, PHARMACIST
Individual provider Active NPI Pharmacist · Quinton, VA
NPI 1780419796 · NPPES record last updated Sep 9, 2024
Key facts
- NPI
- 1780419796
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 0202011606 (VA)
- Practice address
- 7300 Market Place Dr
Quinton, VA 23141-1639 - Phone
- (804) 932-8835
- NPI assigned
- Sep 9, 2024
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29499 | NC | MD | Pharmacist |
| 29499 | NY | MD | Pharmacist |
| 0202011606 | VA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 29499 | NC | |
| Pharmacist | 183500000X | 0202011606 | VA | Yes |
| Pharmacist | 183500000X | 29499 | NY |
Addresses
Primary practice location
7300 Market Place Dr
Quinton, VA 23141-1639
Mailing address
7300 Market Place Dr
Quinton, VA 23141-1639
Phone (804) 932-8835
Other providers in Quinton, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 9, 2024. 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.