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General NPI Number Information
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NPI Number | 1588089668
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Entity Type | Individual
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Provider Name | BRIAN ERICKSON PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 02/26/2014
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Last Update Date | 02/26/2014
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Provider Practice Location Address
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Address Line | 31 MAIN AVE N PO BOX F
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City | BAGLEY
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State | MN
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Zip | 56621-8315
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Country | US
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Telephone | 218-694-6210
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Fax |
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Provider Business Mailing Address
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Address Line | 31 MAIN AVE N PO BOX F
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City | BAGLEY
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State | MN
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Zip | 56621-8315
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Country | US
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Telephone | 218-694-6210
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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 | 121222
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License Number State | MN
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