Provider Demographics
NPI:1235887878
Name:ECKARD, MARY
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:ECKARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4440 STATE ROUTE 61
Mailing Address - Street 2:
Mailing Address - City:MOUNT GILEAD
Mailing Address - State:OH
Mailing Address - Zip Code:43338-9781
Mailing Address - Country:US
Mailing Address - Phone:419-947-9373
Mailing Address - Fax:419-947-9373
Practice Address - Street 1:4440 STATE ROUTE 61
Practice Address - Street 2:
Practice Address - City:MOUNT GILEAD
Practice Address - State:OH
Practice Address - Zip Code:43338-9781
Practice Address - Country:US
Practice Address - Phone:419-947-9373
Practice Address - Fax:419-947-9373
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-14
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide