Active NPI
Beverly J Erickson
- Pharmacy Technician
- Coeur d'Alene, ID
National Provider Identifier
1558087148
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy Technician
- License
- 30007902
- Practice address
- 335 W Appleway Ave
Coeur D Alene, ID 83814-9306 - Phone
- (208) 765-1254
- Fax
- (208) 765-1303
- NPI assigned
- Oct 14, 2022
- Last updated
- Oct 14, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy Technician | 183700000X | 30007902 | ID | Primary |
Addresses
Primary practice location
335 W Appleway Ave
Coeur D Alene, ID 83814-9306
Mailing address
6113 N Ormond Rd
Otis Orchards, WA 99027-9733
Phone (509) 435-8704
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30007902 | ID | MD | Pharmacy Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1665705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665705600000",
"number": "1558087148",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6113 N ORMOND RD",
"city": "OTIS ORCHARDS",
"state": "WA",
"postal_code": "990279733",
"telephone_number": "509-435-8704"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "335 W APPLEWAY AVE",
"city": "COEUR D ALENE",
"state": "ID",
"postal_code": "838149306",
"telephone_number": "208-765-1254",
"fax_number": "208-765-1303"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ERICKSON",
"first_name": "BEVERLY",
"middle_name": "J",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-10-14",
"last_updated": "2022-10-14",
"certification_date": "2022-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "183700000X",
"taxonomy_group": "",
"desc": "Pharmacy Technician",
"state": "ID",
"license": "30007902",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coeur d'Alene, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.