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NPI Code Detail

MEDICARE: MR. STEVEN BECKER R.PH

MEDICARE: MR. STEVEN BECKER R.PH
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
11835P1200XPharmacotherapy Pharmacist26013000AIN

General Provider Information

NPI Number : 1336550789
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. STEVEN BECKER R.PH
Provider Business Mailing Address
First Line : 5909 ILLINOIS RD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46804-1159
Country : US
Telephone Number : 260-434-3933
Fax Number : 260-434-3965
Provider Business Practice Location Address
First Line : 5909 ILLINOIS RD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46804-1159
Country : US
Telephone Number : 260-434-3933
Fax Number : 260-434-3965
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2014
Last Update Date : 05/19/2014

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