Provider Demographics
NPI:1346319860
Name:NORBERG, ERIC W (RPH)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:W
Last Name:NORBERG
Suffix:
Gender:M
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:PO BOX 1306
Mailing Address - Street 2:
Mailing Address - City:SOUTHWEST HARBOR
Mailing Address - State:ME
Mailing Address - Zip Code:04679-1306
Mailing Address - Country:US
Mailing Address - Phone:207-244-5588
Mailing Address - Fax:207-244-5718
Practice Address - Street 1:3 VILLAGE GREEN WAY
Practice Address - Street 2:
Practice Address - City:SOUTHWEST HARBOR
Practice Address - State:ME
Practice Address - Zip Code:04679
Practice Address - Country:US
Practice Address - Phone:207-244-5588
Practice Address - Fax:207-244-5718
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPR4284183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist