Provider Demographics
NPI:1356624894
Name:AUSTIN, ERIN MICHELLE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ERIN
Middle Name:MICHELLE
Last Name:AUSTIN
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 1:68 N BELLWOOD RD
Mailing Address - Street 2:
Mailing Address - City:BETHALTO
Mailing Address - State:IL
Mailing Address - Zip Code:62010-1794
Mailing Address - Country:US
Mailing Address - Phone:618-717-7051
Mailing Address - Fax:618-717-7052
Practice Address - Street 1:68 N BELLWOOD RD
Practice Address - Street 2:
Practice Address - City:BETHALTO
Practice Address - State:IL
Practice Address - Zip Code:62010
Practice Address - Country:US
Practice Address - Phone:618-717-7051
Practice Address - Fax:618-717-7052
Is Sole Proprietor?:No
Enumeration Date:2011-09-21
Last Update Date:2018-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010022983183500000X
IL051294637183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist