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General NPI Number Information
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NPI Number | 1063204402
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Entity Type | Individual
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Provider Name | LAUREN ELIZABETH EASTWOOD
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Gender | Female
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Dates
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Enumeration Date | 05/21/2025
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Last Update Date | 05/21/2025
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Provider Practice Location Address
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Address Line | 2101 E IRELAND RD
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City | SOUTH BEND
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State | IN
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Zip | 46614-9156
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Country | US
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Telephone | 574-291-1303
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Fax |
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Provider Business Mailing Address
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Address Line | 4330 N ASPEN DR
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City | WARSAW
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State | IN
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Zip | 46582-6160
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | 67044256A
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License Number State |
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