Provider Demographics
NPI:1962635284
Name:BIBBEY, ERIC WILLIAM (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:WILLIAM
Last Name:BIBBEY
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:PO BOX 20330
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82003-7033
Mailing Address - Country:US
Mailing Address - Phone:307-433-3703
Mailing Address - Fax:
Practice Address - Street 1:5353 YELLOWSTONE RD
Practice Address - Street 2:309
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82009-4178
Practice Address - Country:US
Practice Address - Phone:307-433-3703
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-03
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY3292183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist