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NPI Code Detail

MEDICARE: ERICKA PANEK

MEDICARE: ERICKA PANEK
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist122059MN

General Provider Information

NPI Number : 1992161749
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERICKA PANEK
Provider Business Mailing Address
First Line : 950 11TH ST SW
Second Line :
City : PINE CITY
State : MN
Zip : 55063-2113
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 950 11TH ST SW
Second Line :
City : PINE CITY
State : MN
Zip : 55063-2113
Country : US
Telephone Number : 320-629-6225
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2016
Last Update Date : 01/09/2016

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Directions to “ ERICKA PANEK ” Practice Location

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