Active NPI
Brian Erickson, PHARMD
- Pharmacist
- Mena, AR
National Provider Identifier
1902579584
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PD08381
- Practice address
- 710 4TH St
Mena, AR 71953-3314 - Phone
- (479) 437-3089
- NPI assigned
- Jul 29, 2021
- Last updated
- Feb 27, 2024
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | PD08381 | AR | Primary |
Addresses
Primary practice location
710 4TH St
Mena, AR 71953-3314
Mailing address
710 4TH St
Mena, AR 71953-3314
Phone (479) 437-3089
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200917600A | Medicaid | OK |
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PD08381 | AR | MD | Pharmacist |
Organizations & group practices 3
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.
-
- Durable Medical Equipment & Medical Supplies
- Mena, AR
- NPI 1225985963
-
- Community/Retail Pharmacy
- Mena, AR
- NPI 1316251432
-
- Long Term Care Pharmacy
- Mena, AR
- NPI 1699455303
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1627516800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708992000000",
"number": "1902579584",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "710 4TH ST",
"city": "MENA",
"state": "AR",
"postal_code": "719533314",
"telephone_number": "479-437-3089"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "710 4TH ST",
"city": "MENA",
"state": "AR",
"postal_code": "719533314",
"telephone_number": "479-437-3089"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ERICKSON",
"first_name": "BRIAN",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-07-29",
"last_updated": "2024-02-27",
"certification_date": "2024-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AR",
"license": "PD08381",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200917600A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mena, AR
- Kelley L Easley Dotson, APN PNP-BC
- Ellison Management PLLC (Ellison Family Pharmacy)
- Ellison Management PLLC (Ellison Family Pharmacy)
- Jessica Pauline Ellison, PHARMD
- Levi Ellison, PHARMACIST
- Jo Lee Erickson, OTR/L
- Debra Inevia Fairless, APN
- Faith & Hope Inc (Medi Shop Pharmacy)
- Faith & Hope, Inc (Medi Shop Pharmacy)
- Family Dentistry
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.