Provider Demographics
NPI:1063044766
Name:DIERKING, ERIKA (RPH)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:
Last Name:DIERKING
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 1:450 OHIO PIKE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45255-5235
Mailing Address - Country:US
Mailing Address - Phone:513-528-6131
Mailing Address - Fax:513-528-3678
Practice Address - Street 1:450 OHIO PIKE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-5235
Practice Address - Country:US
Practice Address - Phone:513-528-6131
Practice Address - Fax:513-528-3678
Is Sole Proprietor?:No
Enumeration Date:2020-02-10
Last Update Date:2020-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH0230261835P0018X
OH032229151835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist