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General NPI Number Information
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NPI Number | 1528200136
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Entity Type | Organization
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Legal Business Name | BEACON PHARMACY, LLC
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Dates
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Enumeration Date | 03/27/2009
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Last Update Date | 06/05/2020
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Provider Practice Location Address
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Address Line | 8607 ROBERTS DR STE 150-B
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City | SANDY SPRINGS
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State | GA
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Zip | 30350-2238
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Country | US
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Telephone | 770-709-0124
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Fax |
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Provider Business Mailing Address
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Address Line | 8607 ROBERTS DR STE 150-B
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City | SANDY SPRINGS
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State | GA
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Zip | 30350-2238
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Country | US
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Telephone | 770-709-0124
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | EDITH A ROSATO
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Credential |
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Telephone | 770-518-8272
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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 | PHRE009571
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License Number State | GA
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