MEDICARE: DR. ERIC ANDREW GERHART PHARMD.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	4186	WY

General Provider Information

NPI Number	:	1275118762
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIC ANDREW GERHART PHARMD.

Provider Business Mailing Address
First Line	:	7208 HERITAGE DR
Second Line	:
City	:	CHEYENNE
State	:	WY
Zip	:	82009-1063
Country	:	US
Telephone Number	:	307-630-6974
Fax Number	:

Provider Business Practice Location Address
First Line	:	3565 PIEDMONT RD NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30305-8202
Country	:	US
Telephone Number	:	307-778-7550
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/16/2021
Last Update Date	:	03/16/2021

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