Provider Demographics
NPI:1578735403
Name:EICKHOF, ANDREW C
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:C
Last Name:EICKHOF
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9680 W TROPICANA AVE
Mailing Address - Street 2:SUITE110-104
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-8293
Mailing Address - Country:US
Mailing Address - Phone:702-685-8320
Mailing Address - Fax:702-685-8321
Practice Address - Street 1:9680 W TROPICANA AVE
Practice Address - Street 2:SUITE110-104
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89147-8293
Practice Address - Country:US
Practice Address - Phone:702-685-8320
Practice Address - Fax:702-685-8321
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-01
Last Update Date:2008-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies