Provider Demographics
NPI:1548359763
Name:STRATHMAN, ERIC F (RPH)
Entity type:Individual
Prefix:MR
First Name:ERIC
Middle Name:F
Last Name:STRATHMAN
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 1:20643 150TH ST
Mailing Address - Street 2:
Mailing Address - City:MAQUOKETA
Mailing Address - State:IA
Mailing Address - Zip Code:52060-8729
Mailing Address - Country:US
Mailing Address - Phone:563-583-7379
Mailing Address - Fax:563-583-8846
Practice Address - Street 1:1920 ELM ST
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-3641
Practice Address - Country:US
Practice Address - Phone:563-583-7379
Practice Address - Fax:563-583-8846
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA17665183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist