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NPI Code Detail

MEDICARE: LISA MARIE ECKERT RPH

MEDICARE: LISA MARIE ECKERT RPH
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
1183500000XPharmacistRI02285200NJ

General Provider Information

NPI Number : 1497061444
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA MARIE ECKERT RPH
Provider Business Mailing Address
First Line : 8721 HIGHLAND ST
Second Line :
City : PORT NORRIS
State : NJ
Zip : 08349-3419
Country : US
Telephone Number : 609-319-5019
Fax Number :
Provider Business Practice Location Address
First Line : 907 N HIGH ST
Second Line :
City : MILLVILLE
State : NJ
Zip : 08332-3762
Country : US
Telephone Number : 856-825-7742
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/27/2010
Last Update Date : 08/27/2010

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