Provider Demographics
NPI:1750606133
Name:EICHHOLZ, DONALD G (PHARMD)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:G
Last Name:EICHHOLZ
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 W STATE ST
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:MI
Mailing Address - Zip Code:49058-1605
Mailing Address - Country:US
Mailing Address - Phone:269-945-3777
Mailing Address - Fax:269-945-3065
Practice Address - Street 1:400 W STATE ST
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:MI
Practice Address - Zip Code:49058-1605
Practice Address - Country:US
Practice Address - Phone:269-945-3777
Practice Address - Fax:269-945-3065
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-29
Last Update Date:2021-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302036582183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist