Healthcare Provider Details

I. General information

NPI: 1255857124
Provider Name (Legal Business Name): ALLEN BEARD RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2017
Last Update Date: 03/20/2020
Certification Date: 03/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

739 PARK ST
CUMBERLAND MD
21502-3172
US

IV. Provider business mailing address

8426 MAPLEVILLE RD
BOONSBORO MD
21713-1816
US

V. Phone/Fax

Practice location:
  • Phone: 301-777-7670
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number25203
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number25203
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: