Provider Demographics
NPI:1588974059
Name:EERKES, DAVID (RPH)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:EERKES
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 1:12651 N COMO DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85755-8789
Mailing Address - Country:US
Mailing Address - Phone:520-297-8089
Mailing Address - Fax:520-297-8089
Practice Address - Street 1:955 N WHITE SANDS BLVD
Practice Address - Street 2:
Practice Address - City:ALAMOGORDO
Practice Address - State:NM
Practice Address - Zip Code:88310-6925
Practice Address - Country:US
Practice Address - Phone:575-434-4116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-18
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00006755183500000X
AZS005272183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist