Provider Demographics
NPI:1528830247
Name:HODGES, ELIZABETH IRENE
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:IRENE
Last Name:HODGES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 PALM COTTAGE DR
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:NC
Mailing Address - Zip Code:28443-3671
Mailing Address - Country:US
Mailing Address - Phone:270-316-4671
Mailing Address - Fax:
Practice Address - Street 1:5226 SIGMON RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-1666
Practice Address - Country:US
Practice Address - Phone:910-392-2945
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-25
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20299183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist