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General NPI Number Information
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NPI Number | 1639424328
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Entity Type | Organization
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Legal Business Name | BEAUREGARD DRUGS INC
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Dates
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Enumeration Date | 07/18/2012
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Last Update Date | 02/20/2017
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Provider Practice Location Address
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Address Line | 7667 AL HIGHWAY 51 STE A
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City | OPELIKA
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State | AL
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Zip | 36804-2200
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Country | US
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Telephone | 334-364-9993
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Fax | 334-364-9997
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Provider Business Mailing Address
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Address Line | 7667 AL HIGHWAY 51 STE A
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City | OPELIKA
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State | AL
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Zip | 36804-2200
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Country | US
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Telephone | 334-364-9993
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Fax | 334-364-9997
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Authorized Official
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Title or Position | PRESIDENT
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Name | TUCKER SIMMONS
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Credential |
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Telephone | 334-364-9993
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | 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 | 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 #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 113939
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License Number State | AL
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