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NPI Code Detail

MEDICARE: BEVERLY S TABASKY

MEDICARE: BEVERLY S TABASKY
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
1183500000XPharmacist7927AL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
17927OTHERALSTATE

General Provider Information

NPI Number : 1447789334
Entity Type Code : Individual
Provider Name (Legal Business Name) : BEVERLY S TABASKY
Provider Business Mailing Address
First Line : 2643 HIGHWAY 280
Second Line :
City : ALEXANDER CITY
State : AL
Zip : 35010-3675
Country : US
Telephone Number : 256-234-7172
Fax Number :
Provider Business Practice Location Address
First Line : 2643 HIGHWAY 280
Second Line :
City : ALEXANDER CITY
State : AL
Zip : 35010-3675
Country : US
Telephone Number : 256-234-7172
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2017
Last Update Date : 06/05/2017

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Directions to “ BEVERLY S TABASKY ” Practice Location

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