Provider Demographics
NPI:1043660244
Name:MUSSGNUG, ERICH (PHARMD)
Entity Type:Individual
Prefix:
First Name:ERICH
Middle Name:
Last Name:MUSSGNUG
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 PLAINFIELD RD
Mailing Address - Street 2:
Mailing Address - City:WEST LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03784-2000
Mailing Address - Country:US
Mailing Address - Phone:603-298-8350
Mailing Address - Fax:603-298-0547
Practice Address - Street 1:250 PLAINFIELD RD
Practice Address - Street 2:
Practice Address - City:WEST LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03784-2000
Practice Address - Country:US
Practice Address - Phone:603-298-8350
Practice Address - Fax:603-298-0547
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-17
Last Update Date:2016-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3783183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist