Provider Demographics
NPI:1265088314
Name:MYERS, ERIN ROSE HARTLEY
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:ROSE HARTLEY
Last Name:MYERS
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 1:1375 S 550 W
Mailing Address - Street 2:
Mailing Address - City:CEDAR CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84720-4332
Mailing Address - Country:US
Mailing Address - Phone:435-592-1490
Mailing Address - Fax:
Practice Address - Street 1:633 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CEDAR CITY
Practice Address - State:UT
Practice Address - Zip Code:84720-3548
Practice Address - Country:US
Practice Address - Phone:435-592-1490
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-14
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy