Provider Demographics
NPI:1538255369
Name:BEFORT, ROBERT L (RPH)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:L
Last Name:BEFORT
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 EUREKA ROAD
Mailing Address - Street 2:IN-PT PHARMACY
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661
Mailing Address - Country:US
Mailing Address - Phone:916-784-5471
Mailing Address - Fax:916-784-5434
Practice Address - Street 1:1600 EUREKA ROAD
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661
Practice Address - Country:US
Practice Address - Phone:916-784-4184
Practice Address - Fax:916-784-5000
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2010-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32827183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist