MEDICARE: REBECCA LYNN PEEK 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	13276	AL

General Provider Information

NPI Number	:	1508469230
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA LYNN PEEK RPH

Provider Business Mailing Address
First Line	:	861 COUNTY ROAD 260
Second Line	:
City	:	PISGAH
State	:	AL
Zip	:	35765-7346
Country	:	US
Telephone Number	:	256-605-9339
Fax Number	:

Provider Business Practice Location Address
First Line	:	1916 GAULT AVE N
Second Line	:
City	:	FORT PAYNE
State	:	AL
Zip	:	35967-3418
Country	:	US
Telephone Number	:	256-845-2004
Fax Number	:	256-845-7839

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

Provider Enumeration Date	:	11/17/2020
Last Update Date	:	11/17/2020

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