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NPI Code Detail

MEDICARE: LINDA JEAN ECKLUND

MEDICARE:   LINDA JEAN ECKLUND
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist9522NE

General Provider Information

NPI Number : 1063078012
Entity Type Code : Individual
Provider Name (Legal Business Name) : LINDA JEAN ECKLUND
Provider Business Mailing Address
First Line : 2717 DEL MONTE AVE
Second Line :
City : GRAND ISLAND
State : NE
Zip : 68803-6117
Country : US
Telephone Number : 308-380-1176
Fax Number :
Provider Business Practice Location Address
First Line : 1515 W 2ND ST
Second Line :
City : GRAND ISLAND
State : NE
Zip : 68801-5700
Country : US
Telephone Number : 308-384-8290
Fax Number : 308-380-0731
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2019
Last Update Date : 05/15/2019

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Directions to “ LINDA JEAN ECKLUND ” Practice Location

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