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General NPI Number Information
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NPI Number | 1962440859
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Entity Type | Organization
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Legal Business Name | BEAM & WEASE OF KINGS MOUNTAIN INC
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Dates
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Enumeration Date | 06/03/2006
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Last Update Date | 04/20/2016
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Provider Practice Location Address
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Address Line | 1106 SHELBY RD
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City | KINGS MOUNTAIN
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State | NC
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Zip | 28086-2742
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Country | US
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Telephone | 704-739-1698
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Fax | 704-739-4248
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Provider Business Mailing Address
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Address Line | 1106 SHELBY RD
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City | KINGS MOUNTAIN
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State | NC
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Zip | 28086-2742
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Country | US
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Telephone | 704-739-1698
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Fax | 704-739-4248
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Authorized Official
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Title or Position | OWNER
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Name | DAVID DELLINGER
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Credential | PHARM.D.
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Telephone | 704-739-1698
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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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 08039
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License Number State | NC
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