MEDICARE: DR. REBEKAH LYNN FORD 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	17939	OK
2	183500000X	Pharmacist	S023030	AZ

General Provider Information

NPI Number	:	1639849862
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. REBEKAH LYNN FORD PHARMD

Provider Business Mailing Address
First Line	:	3029 N 2ND AVE
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85705-4601
Country	:	US
Telephone Number	:	214-998-1443
Fax Number	:

Provider Business Practice Location Address
First Line	:	2811 N FLOWING WELLS RD STE 181
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85705-9325
Country	:	US
Telephone Number	:	520-485-1485
Fax Number	:

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

Provider Enumeration Date	:	09/18/2021
Last Update Date	:	09/18/2021

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