Provider Demographics
NPI:1629045091
Name:KAIME, BECKY L (RPH)
Entity Type:Individual
Prefix:MRS
First Name:BECKY
Middle Name:L
Last Name:KAIME
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 1:27TH MEDICAL GROUP/SGHC
Mailing Address - Street 2:224 W D.L. INGRAM AVE
Mailing Address - City:CANNON AFB
Mailing Address - State:NM
Mailing Address - Zip Code:88101-5103
Mailing Address - Country:US
Mailing Address - Phone:575-904-3917
Mailing Address - Fax:575-784-6028
Practice Address - Street 1:27TH MEDICAL GROUP
Practice Address - Street 2:224 W D.L. INGRAM AVE
Practice Address - City:CANNON AFB
Practice Address - State:NM
Practice Address - Zip Code:88103-5103
Practice Address - Country:US
Practice Address - Phone:575-784-4053
Practice Address - Fax:575-784-7494
Is Sole Proprietor?:No
Enumeration Date:2006-03-03
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00005494183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist