Provider Demographics
NPI:1801169578
Name:BECKER, REBECCA J (PHARMD)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:J
Last Name:BECKER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 CHAPEL DR
Mailing Address - Street 2:STE. A
Mailing Address - City:MONETT
Mailing Address - State:MO
Mailing Address - Zip Code:65708-9370
Mailing Address - Country:US
Mailing Address - Phone:417-635-1100
Mailing Address - Fax:417-635-1103
Practice Address - Street 1:100 CHAPEL DR
Practice Address - Street 2:STE. A
Practice Address - City:MONETT
Practice Address - State:MO
Practice Address - Zip Code:65708-9370
Practice Address - Country:US
Practice Address - Phone:417-635-1100
Practice Address - Fax:417-635-1103
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-10
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009016884183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist