Provider Demographics
NPI:1043789407
Name:BOLLINGER, ERIN K (RPH)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:K
Last Name:BOLLINGER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 S BRADLEY HWY
Mailing Address - Street 2:
Mailing Address - City:ROGERS CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49779-2137
Mailing Address - Country:US
Mailing Address - Phone:989-734-2052
Mailing Address - Fax:989-734-7390
Practice Address - Street 1:205 S BRADLEY HWY
Practice Address - Street 2:
Practice Address - City:ROGERS CITY
Practice Address - State:MI
Practice Address - Zip Code:49779-2137
Practice Address - Country:US
Practice Address - Phone:989-734-2052
Practice Address - Fax:989-734-7390
Is Sole Proprietor?:No
Enumeration Date:2018-11-15
Last Update Date:2018-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302044720183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIPENDINGMedicaid