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General NPI Number Information
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NPI Number | 1124135538
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Entity Type | Organization
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Legal Business Name | BEAUMONT PHARMACY LLC
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Dates
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Enumeration Date | 08/23/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 3110 CALDER AVE.
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City | BEAUMONT
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State | TX
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Zip | 77702-1411
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Country | US
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Telephone | 409-866-1429
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Fax | 409-866-3735
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Provider Business Mailing Address
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Address Line | 3110 CALDER ST
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City | BEAUMONT
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State | TX
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Zip | 77702-1411
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Country | US
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Telephone | 409-866-1429
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Fax | 409-866-3735
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Authorized Official
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Title or Position | MANAGER
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Name | TREY HANEY
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Credential |
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Telephone | 409-769-2406
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding 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 | 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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