Healthcare Provider Details

I. General information

NPI: 1922576701
Provider Name (Legal Business Name): BECKY VUE PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2018
Last Update Date: 11/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9900 POPLAR TENT RD STE 124
CONCORD NC
28027-9502
US

IV. Provider business mailing address

5720 HEWITT DR
CHARLOTTE NC
28269-3029
US

V. Phone/Fax

Practice location:
  • Phone: 704-789-9602
  • Fax: 704-795-4266
Mailing address:
  • Phone: 828-432-6846
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number37660
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number27681
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: