Provider Demographics
NPI:1629485321
Name:ECKARD, STEWART (PHARMD)
Entity Type:Individual
Prefix:
First Name:STEWART
Middle Name:
Last Name:ECKARD
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 W MURPHY ST
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:NC
Mailing Address - Zip Code:27025-1923
Mailing Address - Country:US
Mailing Address - Phone:336-548-0049
Mailing Address - Fax:336-548-0059
Practice Address - Street 1:125 W MURPHY ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:NC
Practice Address - Zip Code:27025-1923
Practice Address - Country:US
Practice Address - Phone:336-548-0049
Practice Address - Fax:336-548-0059
Is Sole Proprietor?:No
Enumeration Date:2014-07-15
Last Update Date:2014-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14889183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC14889OtherPHARMACY STATE LICENSE