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General NPI Number Information
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NPI Number | 1114001955
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Entity Type | Organization
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Legal Business Name | BEACH RX, INC.
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 01/25/2023
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Provider Practice Location Address
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Address Line | 41934 HWY 12
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City | AVON
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State | NC
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Zip | 27915
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Country | US
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Telephone | 252-995-3811
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Fax | 252-995-7955
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Provider Business Mailing Address
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Address Line | P.O. BOX 660
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City | AVON
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State | NC
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Zip | 27915
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Country | US
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Telephone | 252-995-3811
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Fax | 252-995-7955
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Authorized Official
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Title or Position | PRESIDENT/PHARMACIST
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Name | MATTHEW THORNBROUGH
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Credential |
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Telephone | 529-995-3811
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 04503
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License Number State | NC
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