Healthcare Provider Details

I. General information

NPI: 1376451237
Provider Name (Legal Business Name): ANDREW BEATY PHARMD; BCCCP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MEDICAL CENTER BLVD
COOKEVILLE TN
38501-4294
US

IV. Provider business mailing address

1 MEDICAL CENTER BLVD
COOKEVILLE TN
38501-4294
US

V. Phone/Fax

Practice location:
  • Phone: 931-783-2682
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835E0208X
TaxonomyEmergency Medicine Pharmacist
License Number40784
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: