Healthcare Provider Details

I. General information

NPI: 1538255369
Provider Name (Legal Business Name): ROBERT L BEFORT R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 02/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 EUREKA ROAD
ROSEVILLE CA
95661
US

IV. Provider business mailing address

1600 EUREKA ROAD IN-PT PHARMACY
ROSEVILLE CA
95661
US

V. Phone/Fax

Practice location:
  • Phone: 916-784-4184
  • Fax: 916-784-5000
Mailing address:
  • Phone: 916-784-5471
  • Fax: 916-784-5434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number32827
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: