Healthcare Provider Details

I. General information

NPI: 1831841089
Provider Name (Legal Business Name): MARISSA ESCHMAN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2022
Last Update Date: 01/19/2022
Certification Date: 01/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6900 BARDSTOWN RD
LOUISVILLE KY
40291-3223
US

IV. Provider business mailing address

270 CEDAR FALLS DR
MT WASHINGTON KY
40047-6602
US

V. Phone/Fax

Practice location:
  • Phone: 502-239-2322
  • Fax:
Mailing address:
  • Phone: 502-409-2934
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number022342
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: