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General NPI Number Information
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NPI Number | 1174707459
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Entity Type | Individual
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Provider Name | CHARLES JAY BEYER PD
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Gender | Male
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Dates
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Enumeration Date | 12/22/2007
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Last Update Date | 12/22/2007
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Provider Practice Location Address
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Address Line | 312 3RD ST
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City | AURORA
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State | IN
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Zip | 47001-1310
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Country | US
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Telephone | 812-926-0552
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Fax | 812-926-0697
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Provider Business Mailing Address
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Address Line | 9704 COLE LN
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City | AURORA
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State | IN
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Zip | 47001-9764
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Country | US
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Telephone | 812-926-2884
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Fax | 812-926-0697
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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 | 26015124A
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License Number State | IN
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