Healthcare Provider Details

I. General information

NPI: 1760465488
Provider Name (Legal Business Name): KIMBERLY BETH BEGANY
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/28/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE
CLEVELAND OH
44195-0001
US

IV. Provider business mailing address

17291 WOODSTOCK RUN
STRONGSVILLE OH
44149-5872
US

V. Phone/Fax

Practice location:
  • Phone: 216-445-5014
  • Fax: 216-445-6377
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number03-3-18232
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: