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General NPI Number Information
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NPI Number | 1184263261
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Entity Type | Individual
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Provider Name | ERIC WILLIAM ALLEN RPH
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Gender | Male
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Dates
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Enumeration Date | 01/06/2020
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Last Update Date | 01/06/2020
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Provider Practice Location Address
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Address Line | WIN DIXIE PHARMACY #2545 2500 BURNSED BLVD
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City | THE VILLAGES
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State | FL
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Zip | 32162
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Country | US
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Telephone | 352-753-7476
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Fax |
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Provider Business Mailing Address
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Address Line | 5339 OLD HICKORY LN
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City | FRUITLAND PARK
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State | FL
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Zip | 34731-6098
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Country | US
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Telephone | 727-421-6432
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Fax |
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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 | PS0024730
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License Number State | FL
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