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General NPI Number Information
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NPI Number | 1144812199
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Entity Type | Individual
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Provider Name | JASON ECKSTEIN PHARMD
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Gender | Male
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Dates
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Enumeration Date | 02/10/2021
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Last Update Date | 02/10/2021
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Provider Practice Location Address
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Address Line | 124 W INDIAN TRL STE C
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City | MILAN
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State | IN
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Zip | 47031-8993
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Country | US
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Telephone | 812-654-6251
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Fax |
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Provider Business Mailing Address
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Address Line | 5694 E COUNTY ROAD 1000 N
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City | SUNMAN
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State | IN
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Zip | 47041-6000
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Country | US
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Telephone | 812-212-5640
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 26025576A
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License Number State | IN
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