Provider Demographics
NPI:1679706279
Name:PAVUSEK, ERICA MARIE (PHARM D)
Entity type:Individual
Prefix:DR
First Name:ERICA
Middle Name:MARIE
Last Name:PAVUSEK
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:MARIE
Other - Last Name:LAUER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARM D
Mailing Address - Street 1:4600 HIGH POINTE BLVD.
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17111
Mailing Address - Country:US
Mailing Address - Phone:717-558-4151
Mailing Address - Fax:717-558-4161
Practice Address - Street 1:4600 HIGH POINTE BLVD
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17111-2447
Practice Address - Country:US
Practice Address - Phone:717-558-4151
Practice Address - Fax:717-558-4151
Is Sole Proprietor?:No
Enumeration Date:2009-08-29
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP441138183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist