Provider Demographics
NPI:1467568840
Name:BECKWITH, DAWN RACHELLE (CPHT)
Entity Type:Individual
Prefix:MS
First Name:DAWN
Middle Name:RACHELLE
Last Name:BECKWITH
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:07652 51 1/2 ST
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:MI
Mailing Address - Zip Code:49056-9796
Mailing Address - Country:US
Mailing Address - Phone:269-330-1705
Mailing Address - Fax:269-639-8972
Practice Address - Street 1:512 PHOENIX ST
Practice Address - Street 2:
Practice Address - City:SOUTH HAVEN
Practice Address - State:MI
Practice Address - Zip Code:49090-1443
Practice Address - Country:US
Practice Address - Phone:269-637-1161
Practice Address - Fax:269-639-8972
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2009-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2215-0203-1193-081183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician