Provider Demographics
NPI:1932253655
Name:ECKENRODE, HOWARD (RPH)
Entity Type:Individual
Prefix:
First Name:HOWARD
Middle Name:
Last Name:ECKENRODE
Suffix:
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 1:216 NE 6TH ST
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32601-5574
Mailing Address - Country:US
Mailing Address - Phone:352-275-2566
Mailing Address - Fax:
Practice Address - Street 1:1621 SW 13TH ST
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-1524
Practice Address - Country:US
Practice Address - Phone:352-373-7212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2013-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS19898183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist