Provider Demographics
NPI:1427284728
Name:BASTIDAS, ERIN ELIZABETH (RPH)
Entity type:Individual
Prefix:DR
First Name:ERIN
Middle Name:ELIZABETH
Last Name:BASTIDAS
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 1:10140 GREEN LEVEL CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519-8132
Mailing Address - Country:US
Mailing Address - Phone:919-460-4681
Mailing Address - Fax:919-469-0859
Practice Address - Street 1:10140 GREEN LEVEL CHURCH RD
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27519-8132
Practice Address - Country:US
Practice Address - Phone:919-460-4681
Practice Address - Fax:919-469-0859
Is Sole Proprietor?:No
Enumeration Date:2009-06-02
Last Update Date:2011-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15421183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist