Healthcare Provider Details

I. General information

NPI: 1376659789
Provider Name (Legal Business Name): ERICA ANTHONY RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12301 SNOW RD
PARMA OH
44130-1002
US

IV. Provider business mailing address

638 WELLFLEET DR
BAY VILLAGE OH
44140-1744
US

V. Phone/Fax

Practice location:
  • Phone: 216-362-2039
  • Fax:
Mailing address:
  • Phone: 440-899-0392
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03-3-21895
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: