Beverly J Erickson

Individual provider Active NPI Pharmacy Technician · Coeur D Alene, ID

NPI 1558087148 · NPPES record last updated Oct 14, 2022

Key facts

NPI
1558087148
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacy Technician 183700000X
License
30007902 (ID)
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
Sex
Female
Sole proprietor
Yes

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 and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
30007902IDMDPharmacy Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Past
since Oct 16, 2022
Accepting new patients
Walgreen Co Past
since Oct 16, 2022
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy Technician 183700000X 30007902 ID Yes

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

Other providers in Coeur D Alene, ID

All providers in Coeur D Alene, ID · Pharmacy Technician in Idaho

Sources for this page

Verify at the official NPI Registry.