Healthcare Provider Details
I. General information
NPI: 1558093062
Provider Name (Legal Business Name): JANICE ANN BEENE RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/24/2022
Last Update Date: 06/24/2022
Certification Date: 06/24/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
317 E 13TH ST
MURFREESBORO AR
71958-9541
US
IV. Provider business mailing address
405 HEMPSTEAD 33 S
NASHVILLE AR
71852-8474
US
V. Phone/Fax
- Phone: 870-285-2111
- Fax:
- Phone: 870-451-3355
- Fax: 870-285-3357
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 183500000X |
| Taxonomy | Pharmacist |
| License Number | PD09348 |
| License Number State | AR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: