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General NPI Number Information
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NPI Number | 1215065586
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Entity Type | Individual
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Provider Name | BEVERLY KAY WILCOX R.PH.
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Gender | Female
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Dates
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Enumeration Date | 03/01/2007
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Last Update Date | 11/13/2013
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Provider Practice Location Address
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Address Line | 208 CIBECUE CIRCLE
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City | SAN CARLOS
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State | AZ
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Zip | 85550
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Country | US
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Telephone | 928-475-7362
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Fax |
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Provider Business Mailing Address
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Address Line | 783 E SYCAMORE ST
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City | GLOBE
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State | AZ
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Zip | 85501-1724
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Country | US
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Telephone | 928-425-8160
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | 3503
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License Number State | MT
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