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General NPI Number Information
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NPI Number | 1750318150
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Entity Type | Organization
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Legal Business Name | BENEFICIAL PHARMACEUTICAL SUPPLY LLC
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Dates
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Enumeration Date | 06/28/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2445 MCCULLOUGH BLVD
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City | BELDEN
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State | MS
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Zip | 38826
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Country | US
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Telephone | 662-842-8400
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Fax | 662-680-4700
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Provider Business Mailing Address
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Address Line | PO BOX 307
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City | SHERMAN
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State | MS
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Zip | 38869-0307
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Country | US
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Telephone | 662-842-8400
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Fax | 662-680-4700
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. CHARLES L BOATNER JR.
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Credential |
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Telephone | 662-842-8400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State | MS
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