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General NPI Number Information
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NPI Number | 1336240100
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Entity Type | Organization
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Legal Business Name | ECKERD CORPORATION
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 06/17/2009
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Provider Practice Location Address
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Address Line | 100 BLACK HORSE PIKE
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City | AUDUBON
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State | NJ
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Zip | 08106-1950
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Country | US
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Telephone | 856-546-2362
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Fax | 856-546-3732
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Provider Business Mailing Address
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Address Line | 200 NEWBERRY COMMONS
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City | ETTERS
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State | PA
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Zip | 17319-9363
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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 | MANAGER ONLINE ADJUDICATION
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Name | JENNIFER ZOREK
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Credential |
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Telephone | 717-975-5937
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 28RS00487100
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License Number State | NJ
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