Provider Demographics
NPI:1902383508
Name:FROEHLICH, ERIN
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:FROEHLICH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1350 W LAKE LANSING RD
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-1314
Mailing Address - Country:US
Mailing Address - Phone:517-333-3010
Mailing Address - Fax:
Practice Address - Street 1:1350 W LAKE LANSING RD
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-1314
Practice Address - Country:US
Practice Address - Phone:517-333-3010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-26
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03337470183500000X
MI5302411615183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5302411615OtherPHARMACIST LICENSE
OH03337470OtherPHARMACIST LICENSE