Provider Demographics
NPI:1982014601
Name:ELDRIDGE, DORIS (RPH)
Entity Type:Individual
Prefix:MS
First Name:DORIS
Middle Name:
Last Name:ELDRIDGE
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 1:2026 MINNEMAN RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:IN
Mailing Address - Zip Code:47374-9634
Mailing Address - Country:US
Mailing Address - Phone:765-935-4448
Mailing Address - Fax:
Practice Address - Street 1:2507 CHESTER BLVD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:IN
Practice Address - Zip Code:47374-1105
Practice Address - Country:US
Practice Address - Phone:765-939-4410
Practice Address - Fax:765-939-4465
Is Sole Proprietor?:No
Enumeration Date:2014-05-02
Last Update Date:2014-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26018245A1835P1200X
OH031323901835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy