Provider Demographics
NPI:1992137541
Name:BECO PHARMACY LLC
Entity type:Organization
Organization Name:BECO PHARMACY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:BARTH
Authorized Official - Middle Name:A
Authorized Official - Last Name:AKUBUKWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-419-2804
Mailing Address - Street 1:918 E PARK ROW DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76010-4507
Mailing Address - Country:US
Mailing Address - Phone:817-419-2804
Mailing Address - Fax:
Practice Address - Street 1:918 E PARK ROW DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76010-4507
Practice Address - Country:US
Practice Address - Phone:817-419-2804
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-06
Last Update Date:2016-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX286773336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy