MEDICARE: MRS. MARTHA FALLER BECHT RN, BSN

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	163WS0200X	School Registered Nurse	23834	SC

General Provider Information

NPI Number	:	1609115500
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARTHA FALLER BECHT RN, BSN

Provider Business Mailing Address
First Line	:	6801 BROOKFIELD RD
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29206-2205
Country	:	US
Telephone Number	:	803-782-0470
Fax Number	:	803-738-7365

Provider Business Practice Location Address
First Line	:	6801 BROOKFIELD RD
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29206-2205
Country	:	US
Telephone Number	:	803-782-0470
Fax Number	:	803-738-7365

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

Provider Enumeration Date	:	02/12/2013
Last Update Date	:	02/12/2013

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