Provider Demographics
NPI:1760533939
Name:ERP DRUGS, INC
Entity Type:Organization
Organization Name:ERP DRUGS, INC
Other - Org Name:BLOOMFIELD PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EDMUND
Authorized Official - Middle Name:RUDOLPH
Authorized Official - Last Name:PASCUA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:248-333-1130
Mailing Address - Street 1:2520 S TELEGRAPH RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-0285
Mailing Address - Country:US
Mailing Address - Phone:248-333-1130
Mailing Address - Fax:248-333-1133
Practice Address - Street 1:2520 S TELEGRAPH RD
Practice Address - Street 2:SUITE 100
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-0285
Practice Address - Country:US
Practice Address - Phone:248-333-1130
Practice Address - Fax:248-333-1133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53010060113336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2352639Medicaid