Provider Demographics
NPI:1316543275
Name:FRIEDERICH, ERIN ELIZABETH
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:ELIZABETH
Last Name:FRIEDERICH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 E BODLEY AVE
Mailing Address - Street 2:
Mailing Address - City:KIRKWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63122-4422
Mailing Address - Country:US
Mailing Address - Phone:314-795-8165
Mailing Address - Fax:
Practice Address - Street 1:345 DUNN RD
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63031-7929
Practice Address - Country:US
Practice Address - Phone:314-795-8165
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-07
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0512927481835G0303X
MO20090365461835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric