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NPI Code Detail

MEDICARE: KRISTINE BEACH RPH

MEDICARE: KRISTINE BEACH RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist041909NY

General Provider Information

NPI Number : 1033232939
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTINE BEACH RPH
Provider Business Mailing Address
First Line : 2280 N OCEAN AVE
Second Line :
City : FARMINGVILLE
State : NY
Zip : 11738-2911
Country : US
Telephone Number : 631-732-1980
Fax Number : 631-732-6876
Provider Business Practice Location Address
First Line : 2280 N OCEAN AVE
Second Line :
City : FARMINGVILLE
State : NY
Zip : 11738-2911
Country : US
Telephone Number : 631-732-1980
Fax Number : 631-732-6876
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2007
Last Update Date : 07/08/2007

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Directions to “ KRISTINE BEACH RPH” Practice Location

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