=====================================================
General NPI Number Information
=====================================================
NPI Number | 1073535647
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BEAM & CHAPMAN INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/24/2006
-----------------------------------------------------
Last Update Date | 01/28/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 430 WESTERN AVE
-----------------------------------------------------
City | STATESVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28677-5730
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 704-873-7612
-----------------------------------------------------
Fax | 704-872-8037
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 430 WESTERN AVE
-----------------------------------------------------
City | STATESVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28677-5730
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 704-873-7612
-----------------------------------------------------
Fax | 704-872-8037
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | VP
-----------------------------------------------------
Name | KENNETH CHAPMKAN
-----------------------------------------------------
Credential | RPH
-----------------------------------------------------
Telephone | 704-873-7612
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number | 05229
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------