Provider Demographics
NPI:1891017505
Name:NEILSON, ERIC HILDING III (RPH)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:HILDING
Last Name:NEILSON
Suffix:III
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3180 N CAMPBELL AVE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85719-2302
Mailing Address - Country:US
Mailing Address - Phone:520-326-5868
Mailing Address - Fax:520-326-4317
Practice Address - Street 1:3180 N CAMPBELL AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85719-2302
Practice Address - Country:US
Practice Address - Phone:520-326-5868
Practice Address - Fax:520-326-4317
Is Sole Proprietor?:No
Enumeration Date:2010-02-22
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ10885183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist