Provider Demographics
NPI:1639351141
Name:RODD, ERICA ELAINE (PHARMD)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:ELAINE
Last Name:RODD
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:ELAINE
Other - Last Name:FRITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2050 HORICON ST
Mailing Address - Street 2:
Mailing Address - City:MAYVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53050-1423
Mailing Address - Country:US
Mailing Address - Phone:920-387-0257
Mailing Address - Fax:920-387-0272
Practice Address - Street 1:1028 HORICON ST
Practice Address - Street 2:
Practice Address - City:MAYVILLE
Practice Address - State:WI
Practice Address - Zip Code:53050-1429
Practice Address - Country:US
Practice Address - Phone:920-387-7800
Practice Address - Fax:920-387-7809
Is Sole Proprietor?:No
Enumeration Date:2007-11-27
Last Update Date:2014-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI14661-040183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist