Healthcare Provider Details

I. General information

NPI: 1104032655
Provider Name (Legal Business Name): YOLANDA BERNICE MCKOY-BEACH PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 08/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2831 15TH ST NW
WASHINGTON DC
20009-4607
US

IV. Provider business mailing address

2241 RATTAN CT
BRYANS ROAD MD
20616-4240
US

V. Phone/Fax

Practice location:
  • Phone: 202-462-4788
  • Fax:
Mailing address:
  • Phone: 301-283-2873
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License NumberPHA3282
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: