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General NPI Number Information
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NPI Number | 1144734054
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Entity Type | Organization
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Legal Business Name | BEECHMONT PHARMACY, INC.
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Dates
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Enumeration Date | 11/30/2017
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 2025 W EVERLY BROTHERS BLVD
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City | POWDERLY
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State | KY
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Zip | 42367-5401
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Country | US
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Telephone | 270-377-0123
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Fax | 270-377-0126
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Provider Business Mailing Address
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Address Line | 3403 MARYCREST DR
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City | OWENSBORO
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State | KY
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Zip | 42301-6073
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Country | US
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Telephone | 270-314-5440
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Fax | 270-240-4248
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Authorized Official
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Title or Position | CPA/ACCOUNTANT
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Name | THERESA POWERS ELLIOTT
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Credential | CPA
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Telephone | 270-684-3414
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number | P07836
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License Number State | KY
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