Provider Demographics
NPI:1346763216
Name:ELDRED, ERIC A (PHARM D)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:A
Last Name:ELDRED
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6020 B DR N
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49014-8367
Mailing Address - Country:US
Mailing Address - Phone:269-270-1467
Mailing Address - Fax:
Practice Address - Street 1:6020 B DR N
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49014-8367
Practice Address - Country:US
Practice Address - Phone:269-270-1467
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302042021183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist