Healthcare Provider Details

I. General information

NPI: 1306766712
Provider Name (Legal Business Name): JAMES RICHARD BEAL PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95029 SWEETBERRY WAY
FERNANDINA BEACH FL
32034-1143
US

IV. Provider business mailing address

95029 SWEETBERRY WAY
FERNANDINA BEACH FL
32034-1143
US

V. Phone/Fax

Practice location:
  • Phone: 321-626-0478
  • Fax:
Mailing address:
  • Phone: 321-626-0478
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS44988
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: