Individual provider Active NPI

Eric John Lecloux, PHARM D.

  • Pharmacist
  • Luxemburg, WI
National Provider Identifier
1588265169
Registry record updated Nov 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
15922-40 Issued in WI
Practice address
125 School Creek TRL
Luxemburg, WI 54217-1095
Phone
(920) 845-5832
NPI assigned
Nov 2, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 15922-40 WI Primary

Addresses

Primary practice location

125 School Creek TRL
Luxemburg, WI 54217-1095

Mailing address

2753 Blue Spruce Dr
Green Bay, WI 54311-4507
Phone (920) 680-5570

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
15922-40WIMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1604275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604275200000",
    "number": "1588265169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2753 BLUE SPRUCE DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543114507",
            "telephone_number": "920-680-5570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 SCHOOL CREEK TRL",
            "city": "LUXEMBURG",
            "state": "WI",
            "postal_code": "542171095",
            "telephone_number": "920-845-5832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LECLOUX",
        "first_name": "ERIC",
        "middle_name": "JOHN",
        "credential": "PHARM D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-02",
        "last_updated": "2020-11-02",
        "certification_date": "2020-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "15922-40",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Luxemburg, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.