Provider Demographics
NPI:1699084673
Name:MULHERIN, ERLE RIDLEY III (PHARMACIST)
Entity type:Individual
Prefix:MR
First Name:ERLE
Middle Name:RIDLEY
Last Name:MULHERIN
Suffix:III
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 EVERETT ST
Mailing Address - Street 2:
Mailing Address - City:TIPTONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38079-1608
Mailing Address - Country:US
Mailing Address - Phone:731-253-9901
Mailing Address - Fax:
Practice Address - Street 1:730 EVERETT ST
Practice Address - Street 2:
Practice Address - City:TIPTONVILLE
Practice Address - State:TN
Practice Address - Zip Code:38079-1608
Practice Address - Country:US
Practice Address - Phone:731-253-9901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-24
Last Update Date:2010-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNC4248183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist