Provider Demographics
NPI:1821525346
Name:KORTE, ERICA (PHARMD)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:KORTE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:
Other - Last Name:KOZEMCZAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:628 N NEW BALLAS RD STE A
Mailing Address - Street 2:
Mailing Address - City:CREVE COEUR
Mailing Address - State:MO
Mailing Address - Zip Code:63141-6714
Mailing Address - Country:US
Mailing Address - Phone:314-813-2160
Mailing Address - Fax:314-813-2161
Practice Address - Street 1:628 N NEW BALLAS RD STE A
Practice Address - Street 2:
Practice Address - City:CREVE COEUR
Practice Address - State:MO
Practice Address - Zip Code:63141-6714
Practice Address - Country:US
Practice Address - Phone:314-813-2160
Practice Address - Fax:314-813-2161
Is Sole Proprietor?:No
Enumeration Date:2017-05-15
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016027339183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist