Healthcare Provider Details

I. General information

NPI: 1437376076
Provider Name (Legal Business Name): LYNNE CHARLOTTE ECKMANN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

336 ROMANY RD
LEXINGTON KY
40502-2404
US

IV. Provider business mailing address

4190 CLEARWATER WAY
LEXINGTON KY
40515-6021
US

V. Phone/Fax

Practice location:
  • Phone: 859-266-1131
  • Fax:
Mailing address:
  • Phone: 859-273-0219
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number010392
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: