Provider Demographics
NPI:1720393762
Name:EICKMAN, ELIZABETH E (PHARMD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:E
Last Name:EICKMAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:E
Other - Last Name:PERRIGO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:4801 E LINWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64128-2226
Mailing Address - Country:US
Mailing Address - Phone:816-861-4700
Mailing Address - Fax:
Practice Address - Street 1:1111 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CAMERON
Practice Address - State:MO
Practice Address - Zip Code:64429-2005
Practice Address - Country:US
Practice Address - Phone:816-861-4700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-14
Last Update Date:2010-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE13391183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist