Provider Demographics
NPI:1124219829
Name:MADER, ERIN LYNN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:LYNN
Last Name:MADER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15026 STATE HIGHWAY 152
Mailing Address - Street 2:
Mailing Address - City:TORONTO
Mailing Address - State:OH
Mailing Address - Zip Code:43964-7738
Mailing Address - Country:US
Mailing Address - Phone:740-544-6039
Mailing Address - Fax:
Practice Address - Street 1:104 E 5TH ST STE 2
Practice Address - Street 2:
Practice Address - City:EAST LIVERPOOL
Practice Address - State:OH
Practice Address - Zip Code:43920-3031
Practice Address - Country:US
Practice Address - Phone:330-385-6339
Practice Address - Fax:330-385-1400
Is Sole Proprietor?:No
Enumeration Date:2007-08-07
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-3-26733183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist