Healthcare Provider Details

I. General information

NPI: 1063023539
Provider Name (Legal Business Name): EMILY BESKAR PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2020
Last Update Date: 08/10/2020
Certification Date: 08/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

167 N MAIN ST
TUBA CITY AZ
86045
US

IV. Provider business mailing address

PO BOX 600
TUBA CITY AZ
86045-0600
US

V. Phone/Fax

Practice location:
  • Phone: 928-283-2754
  • Fax:
Mailing address:
  • Phone: 928-283-2754
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number20341-40
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: