Provider Demographics
NPI:1891079109
Name:ECKERT, EMILY MARIE (PHARMD)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:MARIE
Last Name:ECKERT
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9748 NORTHERN LAKES LN
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20723-5896
Mailing Address - Country:US
Mailing Address - Phone:412-445-2988
Mailing Address - Fax:
Practice Address - Street 1:2970 SHASHO PL
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20603-4840
Practice Address - Country:US
Practice Address - Phone:301-645-3095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-05
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD19678183500000X
PARP442947183500000X
NJ28RI03228400183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist