Healthcare Provider Details

I. General information

NPI: 1871458349
Provider Name (Legal Business Name): BEWARD PHARMACY CLINIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24082 ROUTE 35 N
MIFFLINTOWN PA
17059-7926
US

IV. Provider business mailing address

24082 ROUTE 35 N
MIFFLINTOWN PA
17059-7926
US

V. Phone/Fax

Practice location:
  • Phone: 717-436-6844
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. GREGORY AGYEMAN-ROCKSON
Title or Position: CEO
Credential:
Phone: 929-231-0673