Healthcare Provider Details

I. General information

NPI: 1306055975
Provider Name (Legal Business Name): ERIN MARIE DEEDS RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 BOULEVARD ST
DOVER OH
44622-2089
US

IV. Provider business mailing address

1620 CRATER AVENUE EXT
DOVER OH
44622-6933
US

V. Phone/Fax

Practice location:
  • Phone: 330-602-9473
  • Fax:
Mailing address:
  • Phone: 330-343-7197
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03-2-17747
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: