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General NPI Number Information
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NPI Number | 1003403361
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Entity Type | Individual
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Provider Name | DR. KENNETH JAMES BEEBE JR.
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Gender | Male
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Dates
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Enumeration Date | 12/21/2020
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Last Update Date | 12/21/2020
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Provider Practice Location Address
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Address Line | 1255 W LANDIS AVE
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City | VINELAND
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State | NJ
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Zip | 08360-3462
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Country | US
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Telephone | 856-794-2989
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Fax |
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Provider Business Mailing Address
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Address Line | 221 MANSION AVE
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City | WEST DEPTFORD
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State | NJ
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Zip | 08086-2539
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Country | US
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Telephone | 856-384-9668
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 28RI03078700
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License Number State | NJ
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