Provider Demographics
NPI:1407214976
Name:HEINZEN COX, ERIN LYNNE (PHARMD)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:LYNNE
Last Name:HEINZEN COX
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:
Other - Last Name:HEINZEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD
Mailing Address - Street 1:702 SW 8TH ST
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72716-6902
Mailing Address - Country:US
Mailing Address - Phone:479-273-4000
Mailing Address - Fax:
Practice Address - Street 1:288 LARKIN DR
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NY
Practice Address - Zip Code:10950-4911
Practice Address - Country:US
Practice Address - Phone:845-783-3505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-29
Last Update Date:2016-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY060405183500000X
NC16251183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist