Provider Demographics
NPI:1942581335
Name:HOBERG, ERIC CARL (PHARM D)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:CARL
Last Name:HOBERG
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1017 VERMILLION ST
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:MN
Mailing Address - Zip Code:55033-2840
Mailing Address - Country:US
Mailing Address - Phone:651-438-0433
Mailing Address - Fax:
Practice Address - Street 1:1017 VERMILLION ST
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:MN
Practice Address - Zip Code:55033-2840
Practice Address - Country:US
Practice Address - Phone:651-438-0433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-30
Last Update Date:2011-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN118773183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist