Provider Demographics
NPI:1932721230
Name:MORSE, ERIC EDWARD (RPH)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:EDWARD
Last Name:MORSE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:WILSENS DRUG STORE
Mailing Address - Street 2:114 FRONT ST
Mailing Address - City:BATH
Mailing Address - State:ME
Mailing Address - Zip Code:04530
Mailing Address - Country:US
Mailing Address - Phone:207-442-8786
Mailing Address - Fax:207-442-7546
Practice Address - Street 1:WILSENS DRUG STORE
Practice Address - Street 2:114 FRONT ST
Practice Address - City:BATH
Practice Address - State:ME
Practice Address - Zip Code:04530
Practice Address - Country:US
Practice Address - Phone:207-442-8786
Practice Address - Fax:207-442-7546
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-11
Last Update Date:2020-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA236983336C0003X
MEPR47813336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy