Healthcare Provider Details

I. General information

NPI: 1437738697
Provider Name (Legal Business Name): ERINA SKOTSEN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2021
Last Update Date: 04/05/2021
Certification Date: 04/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 COBB PKWY
RINGGOLD GA
30736-8566
US

IV. Provider business mailing address

354 MAPLE GROVE LN
APISON TN
37302-2237
US

V. Phone/Fax

Practice location:
  • Phone: 706-891-2586
  • Fax: 706-891-2583
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number41607
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH030228
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: