Provider Demographics
NPI:1497771174
Name:LEWIS, ERIN M (PHARMD)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:M
Last Name:LEWIS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1130 MALLARD BAY PL
Mailing Address - Street 2:
Mailing Address - City:POLK CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50226-2258
Mailing Address - Country:US
Mailing Address - Phone:515-984-6680
Mailing Address - Fax:
Practice Address - Street 1:500 MAIN ST
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-6083
Practice Address - Country:US
Practice Address - Phone:515-233-9858
Practice Address - Fax:515-233-9861
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA19864183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist