Provider Demographics
NPI:1225761547
Name:EILER, ANNA
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:EILER
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 1:3938 BRISTOL OAKS DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40299-3586
Mailing Address - Country:US
Mailing Address - Phone:502-727-1708
Mailing Address - Fax:
Practice Address - Street 1:3938 BRISTOL OAKS DR
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40299-3586
Practice Address - Country:US
Practice Address - Phone:502-727-1708
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-05
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY016171183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty