Provider Demographics
NPI:1851793392
Name:BECKETT, ELAINE BARBARA (PHARMD)
Entity Type:Individual
Prefix:MS
First Name:ELAINE
Middle Name:BARBARA
Last Name:BECKETT
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3013 INDIANA ST NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-2626
Mailing Address - Country:US
Mailing Address - Phone:505-715-8515
Mailing Address - Fax:
Practice Address - Street 1:10224 COORS-BY-PASS NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87114
Practice Address - Country:US
Practice Address - Phone:505-897-6935
Practice Address - Fax:505-899-0897
Is Sole Proprietor?:No
Enumeration Date:2014-09-16
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00007116183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist