MEDICARE: DR. ANGEL M BECK PHARM. D

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	013530	KY
2	183500000X	Pharmacist	26977	OH

General Provider Information

NPI Number	:	1417177817
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANGEL M BECK PHARM. D

Provider Business Mailing Address
First Line	:	152 TOWNSHIP ROAD 1353
Second Line	:
City	:	CROWN CITY
State	:	OH
Zip	:	45623-8703
Country	:	US
Telephone Number	:	740-339-3879
Fax Number	:	740-886-0393

Provider Business Practice Location Address
First Line	:	2300 MACCORKLE AVE SE
Second Line	:
City	:	CHARLESTON
State	:	WV
Zip	:	25304-1045
Country	:	US
Telephone Number	:	304-357-4775
Fax Number	:	304-357-4868

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

Provider Enumeration Date	:	04/26/2007
Last Update Date	:	04/22/2008

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