Provider Demographics
NPI:1295029742
Name:CARTER, ERICK D (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:ERICK
Middle Name:D
Last Name:CARTER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1921 W 18TH ST APT B2
Mailing Address - Street 2:
Mailing Address - City:CEDAR FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50613-7118
Mailing Address - Country:US
Mailing Address - Phone:816-582-7953
Mailing Address - Fax:
Practice Address - Street 1:2181 LOGAN AVE
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50703-1005
Practice Address - Country:US
Practice Address - Phone:319-232-6366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-01
Last Update Date:2011-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA20992183500000X
KS1-14973183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist