Provider Demographics
NPI:1790056406
Name:EAGER, JOELLE (RPH)
Entity Type:Individual
Prefix:
First Name:JOELLE
Middle Name:
Last Name:EAGER
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 1:4008 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50265-3889
Mailing Address - Country:US
Mailing Address - Phone:515-491-8754
Mailing Address - Fax:
Practice Address - Street 1:4900 MILLS CIVIC PKWY
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50265-5262
Practice Address - Country:US
Practice Address - Phone:515-223-8166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-26
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA21114183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist