Provider Demographics
NPI:1861470718
Name:VETTER, ERIC ROBERT (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:ROBERT
Last Name:VETTER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 HANOVER DR
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:KY
Mailing Address - Zip Code:40391-8566
Mailing Address - Country:US
Mailing Address - Phone:859-737-2912
Mailing Address - Fax:
Practice Address - Street 1:1107 W LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:KY
Practice Address - Zip Code:40391-1169
Practice Address - Country:US
Practice Address - Phone:859-745-3470
Practice Address - Fax:859-745-3452
Is Sole Proprietor?:No
Enumeration Date:2006-01-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY012252183500000X
MI5302028223183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist