Provider Demographics
NPI:1396386421
Name:PETERSEN, ERIN (PHARMD)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:PETERSEN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:
Other - Last Name:RHODES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:204 VINTAGE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28104-6129
Mailing Address - Country:US
Mailing Address - Phone:240-723-0888
Mailing Address - Fax:
Practice Address - Street 1:3535 OLENTANGY RIVER RD STE Y1322
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3908
Practice Address - Country:US
Practice Address - Phone:614-566-4758
Practice Address - Fax:614-533-0520
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-30
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03330918183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist