Healthcare Provider Details

I. General information

NPI: 1649535790
Provider Name (Legal Business Name): ERIK GRIFFING PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/05/2012
Last Update Date: 09/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

619 S MARION AVE
LAKE CITY FL
32025-5808
US

IV. Provider business mailing address

2330 SW WILLISTON RD APT 1117
GAINESVILLE FL
32608-4000
US

V. Phone/Fax

Practice location:
  • Phone: 386-755-3016
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number5302038829
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: