MEDICARE: BEARD DRUG INC

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	3336C0003X	Community/Retail Pharmacy	0406202	AR
2	332B00000X	Durable Medical Equipment & Medical Supplies	0406202	AR
3	183500000X	Pharmacist	0406202	AR

General Provider Information

NPI Number	:	1942337811
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEARD DRUG INC

Provider Business Mailing Address
First Line	:	614 S LINCOLN AVE
Second Line	:
City	:	STAR CITY
State	:	AR
Zip	:	71667-5802
Country	:	US
Telephone Number	:	870-628-4277
Fax Number	:	870-628-4278

Provider Business Practice Location Address
First Line	:	614 S LINCOLN AVE
Second Line	:
City	:	STAR CITY
State	:	AR
Zip	:	71667-5802
Country	:	US
Telephone Number	:	870-628-4277
Fax Number	:	870-628-4278

Authorized Official
Title or Position	:	PHARMACIST OWNER
Name	:	ROLAND EDWARD BEARD
Credential	:
Telephone Number	:	870-628-4277

Provider Enumeration Date	:	02/27/2007
Last Update Date	:	01/18/2008

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Directions to “BEARD DRUG INC ” Practice Location

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