Provider Demographics
NPI:1841572765
Name:WOODMAN, ERICA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ERICA
Middle Name:
Last Name:WOODMAN
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 1:94 MARTIN ST
Mailing Address - Street 2:PO BOX 489
Mailing Address - City:ESSEX
Mailing Address - State:MA
Mailing Address - Zip Code:01929-1215
Mailing Address - Country:US
Mailing Address - Phone:978-790-4035
Mailing Address - Fax:
Practice Address - Street 1:616 FOREST AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04101-1510
Practice Address - Country:US
Practice Address - Phone:207-761-9454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-16
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPR6240183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist