# ERICKSON PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992343289
- **Authorized official:** DIANE COLLIER (OWNER)
- **Authorized official phone:** (715) 823-2106

## Contact information

- **Practice address:** 8 S MAIN ST, CLINTONVILLE, WI 54929-1565
- **Practice address phone:** (715) 823-2222
- **Practice address fax:** (715) 823-6000
- **Mailing address:** 8 SOUTH MAIN ST, CLINTONVILLE, WI 54929-1565
- **Mailing address phone:** (715) 823-2222
- **Mailing address fax:** (715) 823-6000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 12/17/2019
- **Last updated:** 12/17/2019