Basic Information
Provider Information
NPI: 1528554573
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHLOSSER
FirstName: ELIZABETH
MiddleName: G.
NamePrefix:  
NameSuffix:  
Credential: PHARMD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 635283
Address2:  
City: CINCINNATI
State: OH
PostalCode: 452635283
CountryCode: US
TelephoneNumber: 8593445555
FaxNumber: 8593445552
Practice Location
Address1: 1360 DOLWICK DRIVE
Address2:  
City: ERLANGER
State: KY
PostalCode: 41018
CountryCode: US
TelephoneNumber: 8593445555
FaxNumber: 8593445552
Other Information
ProviderEnumerationDate: 07/02/2018
LastUpdateDate: 07/29/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/29/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
183500000X019345KYY Pharmacy Service ProvidersPharmacist 
1835P2201X019345KYN    

No ID Information.


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