Provider Demographics
NPI:1760006662
Name:MCDOUGAL, EREKA L (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:EREKA
Middle Name:L
Last Name:MCDOUGAL
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 1:190 N BOULDER HWY
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89015-5308
Mailing Address - Country:US
Mailing Address - Phone:702-565-7805
Mailing Address - Fax:702-565-1546
Practice Address - Street 1:190 N BOULDER HWY
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89015-5308
Practice Address - Country:US
Practice Address - Phone:702-565-7805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-05
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV19125183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist