Provider Demographics
NPI:1225539299
Name:LAFORTE, ERICA (RPH)
Entity Type:Individual
Prefix:DR
First Name:ERICA
Middle Name:
Last Name:LAFORTE
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 1:1000 PARK AVE W
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44906-2810
Mailing Address - Country:US
Mailing Address - Phone:419-529-3790
Mailing Address - Fax:
Practice Address - Street 1:1000 PARK AVE W
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44906-2810
Practice Address - Country:US
Practice Address - Phone:651-698-6502
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-26
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN123105183500000X
OH03441613183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist