Healthcare Provider Details

I. General information

NPI: 1932485562
Provider Name (Legal Business Name): EDWARD D BECKER RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2011
Last Update Date: 10/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2203 BEECHMONT AVE
CINCINNATI OH
45230
US

IV. Provider business mailing address

2203 BEECHMONT AVE
CINCINNATI OH
45230-1518
US

V. Phone/Fax

Practice location:
  • Phone: 513-232-7200
  • Fax:
Mailing address:
  • Phone: 513-232-7200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number18402
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: