MEDICARE: SAMANTHA BECK PHARMD

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	21400	AL

General Provider Information

NPI Number	:	1174135560
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMANTHA BECK PHARMD

Provider Business Mailing Address
First Line	:	2920 CARTER HILL RD
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36106-2531
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2920 CARTER HILL RD
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36106-2531
Country	:	US
Telephone Number	:	334-262-1169
Fax Number	:

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

Provider Enumeration Date	:	08/18/2020
Last Update Date	:	08/18/2020

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