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General NPI Number Information
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NPI Number | 1518010420
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Entity Type | Individual
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Provider Name | DALE MARTIN ERICKSON PHARM. D.
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Gender | Male
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Dates
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Enumeration Date | 01/22/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 7110 BACHMAN RD
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City | SARDINIA
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State | OH
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Zip | 45171-9456
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Country | US
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Telephone | 937-446-2545
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Fax | 937-446-2600
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Provider Business Mailing Address
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Address Line | 2847 LITTLE DRY RUN RD
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City | CINCINNATI
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State | OH
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Zip | 45244-2829
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Country | US
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Telephone | 513-474-5024
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Fax | 513-474-5955
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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 | 03114704
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License Number State | OH
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