Healthcare Provider Details

I. General information

NPI: 1124322524
Provider Name (Legal Business Name): ANN ELIZABETH BEJCEK R.PH.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/29/2010
Last Update Date: 12/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 N CENTER ST
STATESVILLE NC
28677-5235
US

IV. Provider business mailing address

215 N CENTER ST
STATESVILLE NC
28677-5235
US

V. Phone/Fax

Practice location:
  • Phone: 704-872-6591
  • Fax: 704-873-1496
Mailing address:
  • Phone: 704-872-6591
  • Fax: 704-873-1496

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number06228
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: