Provider Demographics
NPI:1487955324
Name:EBERLE, ANTHONY JAMES (RPH)
Entity type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:JAMES
Last Name:EBERLE
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 1:2750 GATEWAY ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OR
Mailing Address - Zip Code:97477-1172
Mailing Address - Country:US
Mailing Address - Phone:541-741-1547
Mailing Address - Fax:541-603-7804
Practice Address - Street 1:2750 GATEWAY ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97477-1172
Practice Address - Country:US
Practice Address - Phone:541-741-1547
Practice Address - Fax:541-603-7804
Is Sole Proprietor?:No
Enumeration Date:2010-11-09
Last Update Date:2019-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR9226183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist