MR. Eric Lee Black, R.PH

NPI #1598877961 in Mount Vernon, Illinois

Provider Information

NPI Number: 1598877961
Entity Type: Individual
Name: MR. Eric Lee Black, R.PH
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Pharmacist
Credential: R.PH
Enumeration Date: Aug 31, 2006
Last Updated: Jul 9, 2007

Practice Location

Address: 2339 BROADWAY ST
City: Mount Vernon
State: Illinois
ZIP Code: 62864-2925
Phone: (618) 242-8776

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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