Provider Demographics
NPI:1275915209
Name:KOEGLE, ERIC RICHARD (MSPS PHARMD RPH)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:RICHARD
Last Name:KOEGLE
Suffix:
Gender:M
Credentials:MSPS PHARMD RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5848 MCCLINTOCK DR
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:NC
Mailing Address - Zip Code:28037-0198
Mailing Address - Country:US
Mailing Address - Phone:440-241-1401
Mailing Address - Fax:
Practice Address - Street 1:1071 7TH STREET CT SE
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-3964
Practice Address - Country:US
Practice Address - Phone:828-358-2310
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-25
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC25157183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist