Healthcare Provider Details

I. General information

NPI: 1225640964
Provider Name (Legal Business Name): JOSEPH WILLIAM BLAND BEATY PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2020
Last Update Date: 08/22/2020
Certification Date: 08/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 S MORTON ST
FRANKLIN IN
46131-2102
US

IV. Provider business mailing address

20 S MORTON ST
FRANKLIN IN
46131-2102
US

V. Phone/Fax

Practice location:
  • Phone: 317-736-8089
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number26026795A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: