Provider Demographics
NPI:1356403026
Name:BICKEL, ERIC D (RPH, MBA)
Entity type:Individual
Prefix:MR
First Name:ERIC
Middle Name:D
Last Name:BICKEL
Suffix:
Gender:M
Credentials:RPH, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3425 INGERSOLL AVE
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50312-3915
Mailing Address - Country:US
Mailing Address - Phone:515-255-8642
Mailing Address - Fax:515-255-6099
Practice Address - Street 1:3425 INGERSOLL AVE
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50312-3915
Practice Address - Country:US
Practice Address - Phone:515-255-8642
Practice Address - Fax:515-255-6099
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA19090183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist