Provider Demographics
NPI:1528169372
Name:HUKLE, EDDIE JAMES (RPH, PHARMD)
Entity type:Individual
Prefix:DR
First Name:EDDIE
Middle Name:JAMES
Last Name:HUKLE
Suffix:
Gender:M
Credentials:RPH, PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19319 NW 230 STREET
Mailing Address - Street 2:
Mailing Address - City:HIGH SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32643
Mailing Address - Country:US
Mailing Address - Phone:180-030-8838
Mailing Address - Fax:
Practice Address - Street 1:619 SOUTH MARION AVE
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32056-9000
Practice Address - Country:US
Practice Address - Phone:180-030-8838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2014-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL14792183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist