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Individual
MR. JACK H EATON
Active
Individual
MR. JACK H EATON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0238781
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00263410
—
NY
01
—
023878
PHARMACIST LICENSE
NY
01
—
3326673
NABP
—
Enumeration date
01/19/2006
Last updated
06/16/2009
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