Provider Demographics
NPI:1467962647
Name:EICHWALD, KARL ALEXANDER (PHARM D)
Entity Type:Individual
Prefix:
First Name:KARL
Middle Name:ALEXANDER
Last Name:EICHWALD
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8800 OPPORTUNITY DR NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-5118
Mailing Address - Country:US
Mailing Address - Phone:505-362-7018
Mailing Address - Fax:
Practice Address - Street 1:8800 OPPORTUNITY DR NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-5118
Practice Address - Country:US
Practice Address - Phone:505-362-7018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-02
Last Update Date:2017-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00008821183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist