Provider Demographics
NPI:1982683033
Name:HEGEDUS, ELINORE LOUISE (RPH)
Entity Type:Individual
Prefix:MS
First Name:ELINORE
Middle Name:LOUISE
Last Name:HEGEDUS
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 1:218 DOUGLAS CT
Mailing Address - Street 2:
Mailing Address - City:SPRING LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:49456-1927
Mailing Address - Country:US
Mailing Address - Phone:616-847-6040
Mailing Address - Fax:
Practice Address - Street 1:3410 REMEMBRANCE RD NW
Practice Address - Street 2:
Practice Address - City:WALKER
Practice Address - State:MI
Practice Address - Zip Code:49534-7744
Practice Address - Country:US
Practice Address - Phone:616-791-0383
Practice Address - Fax:616-791-8343
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302025284183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist