Individual
CHARLES EDWARD SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
3800 PINE AVE, ERIE, PA 16504-2328
(814) 825-1564
Mailing address
1133 W 27TH ST, ERIE, PA 16508-1523
(814) 572-6642
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP456483
PA
Other
Enumeration date
10/03/2022
Last updated
10/03/2022
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