Individual provider Active NPI

Randall Dennis Beck, RPH

  • Pharmacist
  • Caro, MI
National Provider Identifier
1609125392
Registry record updated Sep 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302025541 Issued in MI
Practice address
192 N State St
Caro, MI 48723-1550
Phone
(989) 672-3500
Fax
(989) 672-3555
NPI assigned
Sep 10, 2012
Last updated
Sep 10, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302025541 MI Primary

Addresses

Primary practice location

192 N State St
Caro, MI 48723-1550

Mailing address

192 N State St
Caro, MI 48723-1550
Phone (989) 672-3500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
5302025541MIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
State Street Pharmacy & Wellness Center Inc Current Accepting new patients
State Street Pharmacy LTC CurrentSince Mar 12, 2024 Accepting new patients

Locations

192 N State St
Caro, MI 48723
Phone (989) 672-3500

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1347235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347235200000",
    "number": "1609125392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "192 N STATE ST",
            "city": "CARO",
            "state": "MI",
            "postal_code": "487231550",
            "telephone_number": "989-672-3500",
            "fax_number": "989-672-3555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "192 N STATE ST",
            "city": "CARO",
            "state": "MI",
            "postal_code": "487231550",
            "telephone_number": "989-672-3500",
            "fax_number": "989-672-3555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECK",
        "first_name": "RANDALL",
        "middle_name": "DENNIS",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-10",
        "last_updated": "2012-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302025541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Caro, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.