Provider Demographics
NPI:1093550519
Name:BECK RX PHARMACY, INC.
Entity type:Organization
Organization Name:BECK RX PHARMACY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:MR
Authorized Official - First Name:ERICK
Authorized Official - Middle Name:CORREY
Authorized Official - Last Name:DEETON
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:916-736-3188
Mailing Address - Street 1:3100 STOCKTON BLVD
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95820-1417
Mailing Address - Country:US
Mailing Address - Phone:916-736-3188
Mailing Address - Fax:916-736-2028
Practice Address - Street 1:3100 STOCKTON BLVD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95820-1417
Practice Address - Country:US
Practice Address - Phone:916-736-3188
Practice Address - Fax:916-736-2028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-26
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy