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Individual
CHARLES PAUL ERICKSON
Active
Individual
CHARLES PAUL ERICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.PH.
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
112562
MN
183500000X
Pharmacist
Primary
155110-40
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
112562
PHARMACIST LICENSE
MN
01
—
155110-40
PHARMACIST LICENSE
WI
Enumeration date
04/27/2012
Last updated
04/27/2012
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