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General NPI Number Information
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NPI Number | 1114479896
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Entity Type | Individual
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Provider Name | HEATH EISENBARTH PHARMD
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Gender | Male
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Dates
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Enumeration Date | 10/28/2016
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Last Update Date | 10/28/2016
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Provider Practice Location Address
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Address Line | 402 MAIN ST BOX 353
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City | WESTMORELAND
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State | KS
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Zip | 66549-9836
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Country | US
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Telephone | 785-457-3611
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Fax | 785-457-3622
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Provider Business Mailing Address
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Address Line | 402 MAIN ST BOX 353
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City | WESTMORELAND
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State | KS
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Zip | 66549-9836
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Country | US
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Telephone | 785-457-3611
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Fax | 785-457-3622
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 1-100143
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License Number State | KS
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