MEDICARE: MR. CHAD ERIC BEANE PHARMACIST

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
1	183500000X	Pharmacist	3184	NH

General Provider Information

NPI Number	:	1386633006
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHAD ERIC BEANE PHARMACIST

Provider Business Mailing Address
First Line	:	29 AUDREY LN
Second Line	:
City	:	LACONIA
State	:	NH
Zip	:	03246-3065
Country	:	US
Telephone Number	:	603-528-6008
Fax Number	:

Provider Business Practice Location Address
First Line	:	1400 LAKE SHORE RD
Second Line	:
City	:	GILFORD
State	:	NH
Zip	:	03249-2249
Country	:	US
Telephone Number	:	603-524-5240
Fax Number	:	603-528-8063

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/14/2005
Last Update Date	:	07/08/2007

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