Becky S Drugstore LLC
Organization Active NPI Community/Retail Pharmacy · Buena Vista, GA
NPI 1649520255 · NPPES record last updated May 8, 2013
Key facts
- NPI
- 1649520255
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- PHRE009868 (GA)
- Legal business name
- BECKY S DRUGSTORE LLC
- Practice address
- 128 N Broad St
Buena Vista, GA 31803-2006 - Phone
- (229) 649-3784
- Fax
- (229) 649-7455
- NPI assigned
- Sep 12, 2012
- Organization subpart
- No
Authorized official
- Name
- Becky Powell
- Title
- Owner/RPH
- Phone
- (229) 314-1966
Practitioners 1
-
Becky M Powell, RPH
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240320001793 | GA | Part B Supplier - Pharmacy | 6204273741 | Practice locations: Buena Vista, GA |
National Provider Directory
Locations
128 N Broad St
Buena Vista, GA 31803
Phone (229) 314-9166
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | PHRE009868 | GA | Yes |
Addresses
Primary practice location
128 N Broad St
Buena Vista, GA 31803-2006
Mailing address
PO Box 560
Buena Vista, GA 31803-0560
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2136730 | Other | PK |
Other names
- Becky's Drugstore
Other providers in Buena Vista, GA
- Buena Vista Family Clinic
- Burtons Enterprise Inc
- Careconnect Health, Inc
- Judy H. Catrett
- William Frank Catrett
All providers in Buena Vista, GA · Community/Retail Pharmacy in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 8, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.