Provider Demographics
NPI:1376689489
Name:EICHHORST, MICHELE DENICE (RPH)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:DENICE
Last Name:EICHHORST
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1824 20TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55906-8000
Mailing Address - Country:US
Mailing Address - Phone:507-282-7343
Mailing Address - Fax:
Practice Address - Street 1:MAYO CLINIC 200 FIRST ST SW
Practice Address - Street 2:WF 5-21D
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55905-0001
Practice Address - Country:US
Practice Address - Phone:507-284-3397
Practice Address - Fax:507-266-9757
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN112108-5183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist