Individual
DR. ERIK RANDALL GROVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
835 W MAIN ST, MADISON, IN 47250-3131
(812) 265-4621
(812) 273-6666
Mailing address
1802 SAINT ANDREWS CT, LAGRANGE, KY 40031-8942
(502) 222-9678
(812) 273-6666
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
12150
KY
183500000X
Pharmacist
Primary
26022241A
IN
183500000X
Pharmacist
51291460
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
54023718
—
KY
01
—
9023441000
KENTUCKY MEDICAID DME
KY
Enumeration date
02/08/2007
Last updated
07/09/2007
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