Healthcare Provider Details

I. General information

NPI: 1336121763
Provider Name (Legal Business Name): ERIN MINTER PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/21/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1040 DELAWARE AVE
MARION OH
43302-6416
US

IV. Provider business mailing address

45 WATERS EDGE CIR
DELAWARE OH
43015-1298
US

V. Phone/Fax

Practice location:
  • Phone: 740-383-7979
  • Fax: 740-383-7019
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number03-2-25119
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: