MEDICARE: MRS. REBECCA LYNN WEBB RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	048654	NY

General Provider Information

NPI Number	:	1003085267
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. REBECCA LYNN WEBB RPH

Provider Business Mailing Address
First Line	:	6508A BASILE ROWE
Second Line	:
City	:	EAST SYRACUSE
State	:	NY
Zip	:	13057-2942
Country	:	US
Telephone Number	:	315-433-2300
Fax Number	:	315-433-5300

Provider Business Practice Location Address
First Line	:	2949 ERIE BLVD E
Second Line	:	SUITE 103
City	:	SYRACUSE
State	:	NY
Zip	:	13224-1442
Country	:	US
Telephone Number	:	315-425-8028
Fax Number	:	315-425-0989

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/21/2008
Last Update Date	:	08/01/2011

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