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General NPI Number Information
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NPI Number | 1669705851
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Entity Type | Individual
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Provider Name | BEIMNET KASSAHUN PHARM. D.
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Gender | Male
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Dates
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Enumeration Date | 09/07/2009
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Last Update Date | 09/07/2009
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Provider Practice Location Address
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Address Line | 1325 WASHINGTON ST
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City | PERRY
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State | GA
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Zip | 31069-2565
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Country | US
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Telephone | 478-987-9225
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Fax |
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Provider Business Mailing Address
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Address Line | 5243 RIVERSIDE DR APT 708
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City | MACON
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State | GA
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Zip | 31210-8803
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Country | US
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Telephone | 267-312-8206
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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 | RPH024554
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License Number State | GA
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