Provider Demographics
NPI:1104427244
Name:LUSSIER, ERICA L (RPH)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:L
Last Name:LUSSIER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 SUNSHINE DR
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:NH
Mailing Address - Zip Code:03848-3545
Mailing Address - Country:US
Mailing Address - Phone:603-235-0766
Mailing Address - Fax:
Practice Address - Street 1:6 HAMPTON DR
Practice Address - Street 2:
Practice Address - City:LONDONDERRY
Practice Address - State:NH
Practice Address - Zip Code:03053-3424
Practice Address - Country:US
Practice Address - Phone:603-421-0076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-05
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2838183500000X
MAPH22582183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist