Provider Demographics
NPI:1598208415
Name:ERWIN, ERIC (PHARMD)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:ERWIN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1802 GLEN IVY
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-3594
Mailing Address - Country:US
Mailing Address - Phone:678-986-6526
Mailing Address - Fax:
Practice Address - Street 1:1802 GLEN IVY
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-3594
Practice Address - Country:US
Practice Address - Phone:678-986-6526
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-25
Last Update Date:2016-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH020427183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist