Healthcare Provider Details

I. General information

NPI: 1275721904
Provider Name (Legal Business Name): BEACHY ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2007
Last Update Date: 10/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 BROOKWOOD AVE SUITE B
CARLISLE PA
17015-9168
US

IV. Provider business mailing address

8 BROOKWOOD AVE SUITE B
CARLISLE PA
17015-9168
US

V. Phone/Fax

Practice location:
  • Phone: 717-243-3307
  • Fax: 717-243-9968
Mailing address:
  • Phone: 717-243-3307
  • Fax: 717-243-9968

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier029620
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerMEDICARE
# 2
Identifier616203
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerHIGHMARK BLUE SHIELD
# 3
Identifier03235800
Identifier TypeOTHER
Identifier StatePW
Identifier IssuerCAPTIAL BLIE CROSS

VIII. Authorized Official

Name: SANDRA LEE WINNER
Title or Position: OFFICE MANAGER
Credential:
Phone: 717-243-3307