Provider Demographics
NPI:1588995658
Name:ANGER, ERIC NELSON III (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:NELSON
Last Name:ANGER
Suffix:III
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4645 E DECATUR ST
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85205-6317
Mailing Address - Country:US
Mailing Address - Phone:602-819-0364
Mailing Address - Fax:
Practice Address - Street 1:4645 E DECATUR ST
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85205-6317
Practice Address - Country:US
Practice Address - Phone:602-819-0364
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-28
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ129301835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy