Healthcare Provider Details

I. General information

NPI: 1831665793
Provider Name (Legal Business Name): ERICA PEARL HOVERSLAND PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2018
Last Update Date: 10/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

760 WICKS LN
BILLINGS MT
59105-4427
US

IV. Provider business mailing address

760 WICKS LN
BILLINGS MT
59105-4427
US

V. Phone/Fax

Practice location:
  • Phone: 406-238-2475
  • Fax: 406-238-5546
Mailing address:
  • Phone: 406-238-2475
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License NumberPHA-PHA-LIC-47860
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: