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General NPI Number Information
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NPI Number | 1912263633
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Entity Type | Individual
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Provider Name | ERIC CARLTON PHARM.D., RPH
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Gender | Male
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Dates
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Enumeration Date | 04/06/2012
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Last Update Date | 03/04/2019
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Provider Practice Location Address
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Address Line | 1010 N ROCHESTER ST
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City | MUKWONAGO
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State | WI
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Zip | 53149
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Country | US
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Telephone | 262-363-1680
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Fax |
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Provider Business Mailing Address
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Address Line | 1010 N ROCHESTER ST
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City | MUKWONAGO
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State | WI
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Zip | 53149-8738
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Country | US
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Telephone |
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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 | 16374-040
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License Number State | WI
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