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General NPI Number Information
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NPI Number | 1093835597
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Entity Type | Individual
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Provider Name | WAYNE R BEEKMAN RPH
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Gender | Male
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 01/19/2012
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Provider Practice Location Address
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Address Line | 1400 E PERSHING RD
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City | DECATUR
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State | IL
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Zip | 62526-4733
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Country | US
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Telephone | 217-875-9364
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Fax | 217-875-9377
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Provider Business Mailing Address
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Address Line | 12538 SR 78
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City | HAVANA
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State | IL
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Zip | 62644-6866
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Country | US
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Telephone | 217-496-6063
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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 | 051029800
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License Number State | IL
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