=====================================================
General NPI Number Information
=====================================================
NPI Number | 1689650228
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ERIC J STURGEON PHARM.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/15/2005
-----------------------------------------------------
Last Update Date | 07/13/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 105 W HANFORD ARMONA RD
-----------------------------------------------------
City | LEMOORE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93245-2321
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 559-924-9593
-----------------------------------------------------
Fax | 559-924-5799
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 105 W HANFORD ARMONA RD
-----------------------------------------------------
City | LEMOORE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93245-2321
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 29403
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------