Provider Demographics
NPI:1225208671
Name:BECK, BRENDA J
Entity type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:J
Last Name:BECK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 6TH ST
Mailing Address - Street 2:
Mailing Address - City:TORONTO
Mailing Address - State:OH
Mailing Address - Zip Code:43964-1462
Mailing Address - Country:US
Mailing Address - Phone:740-537-9400
Mailing Address - Fax:740-537-5166
Practice Address - Street 1:206 6TH ST
Practice Address - Street 2:
Practice Address - City:TORONTO
Practice Address - State:OH
Practice Address - Zip Code:43964-1462
Practice Address - Country:US
Practice Address - Phone:740-537-9400
Practice Address - Fax:740-537-5166
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-29
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH200729601258343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)