Healthcare Provider Details

I. General information

NPI: 1356624589
Provider Name (Legal Business Name): ERIC PAUL GOLDEN PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2011
Last Update Date: 12/19/2022
Certification Date: 12/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2515 CRAWFORD RD
PHENIX CITY AL
36867-3629
US

IV. Provider business mailing address

5301 SUMMERVILLE RD
PHENIX CITY AL
36867-7423
US

V. Phone/Fax

Practice location:
  • Phone: 334-297-3722
  • Fax: 334-297-5223
Mailing address:
  • Phone: 334-297-3061
  • Fax: 334-297-0193

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number15868
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: