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General NPI Number Information
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NPI Number | 1225250228
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Entity Type | Individual
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Provider Name | ROGER A BECKER RPH
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Gender | Male
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Dates
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Enumeration Date | 05/02/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3157 WEST 23RD STREET
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City | PANAMA CITY
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State | FL
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Zip | 32405-1828
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Country | US
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Telephone | 850-747-0777
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Fax | 850-747-9010
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Provider Business Mailing Address
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Address Line | 120 GRAND HERON DRIVE
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City | PANAMA CITY BEACH
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State | FL
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Zip | 32407-2401
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Country | US
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Telephone | 850-233-6684
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Fax | 850-233-0474
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS 28163
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License Number State | FL
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