Provider Demographics
NPI:1245514827
Name:RIGGLE, EDWARD JR (RPH)
Entity type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:
Last Name:RIGGLE
Suffix:JR
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 1:9012 RICHLAND DR
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:IN
Mailing Address - Zip Code:47122-8830
Mailing Address - Country:US
Mailing Address - Phone:812-399-1141
Mailing Address - Fax:
Practice Address - Street 1:9012 RICHLAND DR
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:IN
Practice Address - Zip Code:47122-8830
Practice Address - Country:US
Practice Address - Phone:812-399-1141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-30
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26016394A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist