=====================================================
General NPI Number Information
=====================================================
NPI Number | 1659475614
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BEAM & FLYNN INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/12/2006
-----------------------------------------------------
Last Update Date | 06/19/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 202 SEABOARD AVE
-----------------------------------------------------
City | GREENWOOD
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29646-2201
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 864-223-6120
-----------------------------------------------------
Fax | 864-223-0693
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 660
-----------------------------------------------------
City | GREENWOOD
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29648-0660
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 864-223-6120
-----------------------------------------------------
Fax | 864-223-0693
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PIC
-----------------------------------------------------
Name | BRIAN DUFFIE
-----------------------------------------------------
Credential | BS
-----------------------------------------------------
Telephone | 864-223-6120
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number | 50009887
-----------------------------------------------------
License Number State | SC
-----------------------------------------------------