Healthcare Provider Details

I. General information

NPI: 1730258310
Provider Name (Legal Business Name): BECKER PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2006
Last Update Date: 07/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 MAIN ST
WINTERS CA
95694-1930
US

IV. Provider business mailing address

101 MAIN ST
WINTERS CA
95694-1930
US

V. Phone/Fax

Practice location:
  • Phone: 530-795-4123
  • Fax: 530-795-0544
Mailing address:
  • Phone: 530-795-4123
  • Fax: 530-795-0544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number53722
License Number StateCA

VIII. Authorized Official

Name: JODIE BECKER
Title or Position: OWNER
Credential:
Phone: 530-795-4123