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General NPI Number Information
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NPI Number | 1659679264
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Entity Type | Individual
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Provider Name | BETHANY COLLUP BEECHER RPH
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Gender | Female
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Dates
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Enumeration Date | 03/06/2011
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Last Update Date | 03/06/2011
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Provider Practice Location Address
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Address Line | 15 N DIVISION ST NW
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City | ROME
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State | GA
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Zip | 30165-2327
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Country | US
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Telephone | 706-235-5591
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 680062
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City | MARIETTA
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State | GA
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Zip | 30068-0002
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Country | US
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Telephone | 770-509-7581
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Fax |
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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 | 022782
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS41077
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License Number State | FL
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