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General NPI Number Information
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NPI Number | 1619171394
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Entity Type | Individual
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Provider Name | DAVID LEE BEAM RPH
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Gender | Male
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Dates
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Enumeration Date | 06/14/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 820 KLUMAC RD SUITE 100
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City | SALISBURY
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State | NC
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Zip | 28144-5722
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Country | US
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Telephone | 704-642-0952
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Fax | 704-642-0954
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Provider Business Mailing Address
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Address Line | 458 OLD MOUNTAIN RD
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City | STATESVILLE
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State | NC
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Zip | 28677-2066
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Country | US
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Telephone | 704-528-3106
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Fax | 704-642-0954
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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 | 08381
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License Number State | NC
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