Provider Demographics
NPI:1275101354
Name:RUSH, ERICA NOEL (PHARMD)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:NOEL
Last Name:RUSH
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 1:677 ST BENEDICT RD
Mailing Address - Street 2:
Mailing Address - City:BENDENA
Mailing Address - State:KS
Mailing Address - Zip Code:66008-8138
Mailing Address - Country:US
Mailing Address - Phone:816-261-1375
Mailing Address - Fax:
Practice Address - Street 1:101 N MAIN ST
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:KS
Practice Address - Zip Code:66087-4140
Practice Address - Country:US
Practice Address - Phone:785-982-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-15
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020020049183500000X
KS1-100812183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist