Provider Demographics
NPI:1568643849
Name:EAGLETON, RICHARD F (PHARMACIST)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:F
Last Name:EAGLETON
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 CALLINGHAM ROAD
Mailing Address - Street 2:
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-1502
Mailing Address - Country:US
Mailing Address - Phone:585-385-0999
Mailing Address - Fax:
Practice Address - Street 1:1601 PENFIELD ROAD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14625
Practice Address - Country:US
Practice Address - Phone:585-264-0824
Practice Address - Fax:585-264-1264
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-15
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025868183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist