Provider Demographics
NPI:1013211531
Name:STEWART, BECKI AF (RPH)
Entity Type:Individual
Prefix:
First Name:BECKI
Middle Name:AF
Last Name:STEWART
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44805-4011
Mailing Address - Country:US
Mailing Address - Phone:419-289-0491
Mailing Address - Fax:419-289-2831
Practice Address - Street 1:1025 CENTER ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OH
Practice Address - Zip Code:44805-4011
Practice Address - Country:US
Practice Address - Phone:419-289-0491
Practice Address - Fax:419-289-2831
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-23
Last Update Date:2010-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03119145183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist