Provider Demographics
NPI:1598977001
Name:EALY, RICK EUGENE (DPH)
Entity Type:Individual
Prefix:MR
First Name:RICK
Middle Name:EUGENE
Last Name:EALY
Suffix:
Gender:M
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 APPIAN WAY
Mailing Address - Street 2:
Mailing Address - City:GREENEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37745
Mailing Address - Country:US
Mailing Address - Phone:423-639-0456
Mailing Address - Fax:
Practice Address - Street 1:1420 TUSCULUM BLVD.
Practice Address - Street 2:LAUGHLIN MEMORIAL HOSPITAL PHARMACY
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37745
Practice Address - Country:US
Practice Address - Phone:423-787-5065
Practice Address - Fax:423-787-5067
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3795183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist