MEDICARE: JEFF SCOTT NORBECK

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	07600	AR

General Provider Information

NPI Number	:	1598032179
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFF SCOTT NORBECK

Provider Business Mailing Address
First Line	:	3349 N RAINBOW FARM RD
Second Line	:
City	:	BENTONVILLE
State	:	AR
Zip	:	72712-9464
Country	:	US
Telephone Number	:	479-616-0230
Fax Number	:

Provider Business Practice Location Address
First Line	:	3499 BELLA VISTA WAY
Second Line	:
City	:	BELLA VISTA
State	:	AR
Zip	:	72714-5740
Country	:	US
Telephone Number	:	479-273-9136
Fax Number	:

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

Provider Enumeration Date	:	11/26/2011
Last Update Date	:	11/26/2011

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