Healthcare Provider Details

I. General information

NPI: 1144612458
Provider Name (Legal Business Name): ERIKA BRINSON PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2015
Last Update Date: 02/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2150 DIXIE HWY
FORT MITCHELL KY
41017-2902
US

IV. Provider business mailing address

2150 DIXIE HWY
FORT MITCHELL KY
41017-2902
US

V. Phone/Fax

Practice location:
  • Phone: 859-331-0078
  • Fax: 859-331-3478
Mailing address:
  • Phone: 859-331-0078
  • Fax: 859-331-3478

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number015151
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03230160
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS 48857
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH026408
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: