Provider Demographics
NPI:1790755247
Name:DURBIN, ERIC M (RPH)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:M
Last Name:DURBIN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9559 ROWE RD NW
Mailing Address - Street 2:
Mailing Address - City:SUGARCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:44681-6902
Mailing Address - Country:US
Mailing Address - Phone:330-364-2301
Mailing Address - Fax:330-343-0264
Practice Address - Street 1:3000 N WOOSTER AVE
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:OH
Practice Address - Zip Code:44622-9469
Practice Address - Country:US
Practice Address - Phone:330-364-2301
Practice Address - Fax:330-343-0264
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-2-21279183500000X, 1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered183500000XPharmacy Service ProvidersPharmacist
Not Answered1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy