Provider Demographics
NPI:1780222174
Name:BOXNICK, ERIC HERMAN (PHARMACISTS)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:HERMAN
Last Name:BOXNICK
Suffix:
Gender:M
Credentials:PHARMACISTS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 W OAK ST
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72032
Mailing Address - Country:US
Mailing Address - Phone:501-329-0795
Mailing Address - Fax:501-329-0593
Practice Address - Street 1:101 WEST OAK STREET
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72032
Practice Address - Country:US
Practice Address - Phone:501-329-0795
Practice Address - Fax:501-329-0593
Is Sole Proprietor?:No
Enumeration Date:2019-12-16
Last Update Date:2019-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD10550183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist