Eric Robert Gresens, RPH
Individual provider Active NPI Pharmacist · Edgerton, WI
NPI 1083733448 · NPPES record last updated Sep 12, 2019
Key facts
- NPI
- 1083733448
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 12874 (WI)
- Practice address
- 711 N Main St
Edgerton, WI 53534-1530 - Phone
- (608) 884-3308
- Fax
- (608) 884-7725
- NPI assigned
- Mar 28, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12874 | WI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rockmed LLC | Current |
Accepting new patients |
Locations
711 N Main St
Edgerton, WI 53534
Phone (608) 884-3308
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 12874 | WI | Yes |
Addresses
Primary practice location
711 N Main St
Edgerton, WI 53534-1530
Mailing address
379 E Samuelsen Dr
Edgerton, WI 53534-8412
Phone (608) 449-0095
Other providers in Edgerton, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 12, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.