MEDICARE: DR. DEBRA ANN 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	4820	ND

General Provider Information

NPI Number	:	1699870345
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEBRA ANN BECK PHARM D

Provider Business Mailing Address
First Line	:	609 MAIN ST
Second Line	:	PO BOX 776
City	:	UNDERWOOD
State	:	ND
Zip	:	58576
Country	:	US
Telephone Number	:	701-442-3629
Fax Number	:

Provider Business Practice Location Address
First Line	:	703 MAIN ST
Second Line	:
City	:	WASHBURN
State	:	ND
Zip	:	58577
Country	:	US
Telephone Number	:	701-462-8174
Fax Number	:	701-462-3597

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

Provider Enumeration Date	:	09/14/2006
Last Update Date	:	07/08/2007

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