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NPI Code Detail

MEDICARE: JODIE ECKENROD

MEDICARE: JODIE ECKENROD
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
1183500000XPharmacistRP041901LPA

General Provider Information

NPI Number : 1518454552
Entity Type Code : Individual
Provider Name (Legal Business Name) : JODIE ECKENROD
Provider Business Mailing Address
First Line : 2903 BIG MEADOW CT
Second Line :
City : BRIDGEVILLE
State : PA
Zip : 15017-1601
Country : US
Telephone Number : 412-257-9797
Fax Number :
Provider Business Practice Location Address
First Line : 955 RIVERMONT DR
Second Line :
City : PITTSBURGH
State : PA
Zip : 15207-1347
Country : US
Telephone Number : 412-422-6800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/16/2018
Last Update Date : 04/16/2018

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Directions to “ JODIE ECKENROD ” Practice Location

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