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General NPI Number Information
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NPI Number | 1396386421
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Entity Type | Individual
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Provider Name | ERIN PETERSEN PHARMD
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Gender | Female
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Dates
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Enumeration Date | 09/30/2019
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Last Update Date | 09/17/2020
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Provider Practice Location Address
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Address Line | 3535 OLENTANGY RIVER RD STE Y1322
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City | COLUMBUS
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State | OH
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Zip | 43214-3908
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Country | US
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Telephone | 614-566-4758
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Fax | 614-533-0520
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Provider Business Mailing Address
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Address Line | 204 VINTAGE CREEK DR
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City | MATTHEWS
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State | NC
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Zip | 28104-6129
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Country | US
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Telephone | 240-723-0888
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 03330918
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License Number State | OH
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