Provider Demographics
NPI:1124343652
Name:EILAND, CARLOS MILTON (RPH)
Entity type:Individual
Prefix:
First Name:CARLOS
Middle Name:MILTON
Last Name:EILAND
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 1:139 E BROAD ST
Mailing Address - Street 2:
Mailing Address - City:EUFAULA
Mailing Address - State:AL
Mailing Address - Zip Code:36027-2023
Mailing Address - Country:US
Mailing Address - Phone:334-687-2061
Mailing Address - Fax:
Practice Address - Street 1:139 E BROAD ST
Practice Address - Street 2:
Practice Address - City:EUFAULA
Practice Address - State:AL
Practice Address - Zip Code:36027-2023
Practice Address - Country:US
Practice Address - Phone:334-687-2061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-27
Last Update Date:2010-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL7894183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist