Provider Demographics
NPI:1710273230
Name:SAWYER, BECKY JO BURGESS (RPH)
Entity Type:Individual
Prefix:MRS
First Name:BECKY JO
Middle Name:BURGESS
Last Name:SAWYER
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 1:1245 CONCORD PKWY N
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-4325
Mailing Address - Country:US
Mailing Address - Phone:704-795-9868
Mailing Address - Fax:704-788-3805
Practice Address - Street 1:1245 CONCORD PKWY N
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-4325
Practice Address - Country:US
Practice Address - Phone:704-795-9868
Practice Address - Fax:704-788-3805
Is Sole Proprietor?:No
Enumeration Date:2011-06-22
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6340183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist