Provider Demographics
NPI:1902420003
Name:BECKER PHARMACY INC
Entity Type:Organization
Organization Name:BECKER PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JODIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BECKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-719-0012
Mailing Address - Street 1:101 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WINTERS
Mailing Address - State:CA
Mailing Address - Zip Code:95694-1930
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:16858 YOLO AVE
Practice Address - Street 2:
Practice Address - City:ESPARTO
Practice Address - State:CA
Practice Address - Zip Code:95627
Practice Address - Country:US
Practice Address - Phone:530-795-3721
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BECKER PHARMACY INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-06-04
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy