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NPI Code Detail

MEDICARE: MR. BRUCE ERIC BECKWITH RPH

MEDICARE: MR. BRUCE ERIC BECKWITH 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
1183500000XPharmacist7711OR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1881624195
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BRUCE ERIC BECKWITH RPH
Provider Business Mailing Address
First Line : 655 NW GREENWOOD AVE
Second Line : SUITE #1
City : REDMOND
State : OR
Zip : 97756-1533
Country : US
Telephone Number : 541-923-3822
Fax Number : 541-923-8754
Provider Business Practice Location Address
First Line : 655 NW GREENWOOD AVE
Second Line : SUITE #1
City : REDMOND
State : OR
Zip : 97756-1533
Country : US
Telephone Number : 541-923-3822
Fax Number : 541-923-8754
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2006
Last Update Date : 07/08/2007

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