MEDICARE: MRS. BECKY J REUTZEL RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	16483	IA

General Provider Information

NPI Number	:	1134110232
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BECKY J REUTZEL RPH

Provider Business Mailing Address
First Line	:	617 8TH AVE SE
Second Line	:
City	:	CEDAR RAPIDS
State	:	IA
Zip	:	52401-2117
Country	:	US
Telephone Number	:	319-364-4181
Fax Number	:	319-363-5448

Provider Business Practice Location Address
First Line	:	617 8TH AVE SE
Second Line	:
City	:	CEDAR RAPIDS
State	:	IA
Zip	:	52401-2117
Country	:	US
Telephone Number	:	319-364-4181
Fax Number	:	319-363-5448

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/31/2005
Last Update Date	:	02/16/2012

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