MEDICARE: LINDA P BEARDEN

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	015488	GA

General Provider Information

NPI Number	:	1972676690
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA P BEARDEN

Provider Business Mailing Address
First Line	:	929 HUGH STOWERS RD
Second Line	:
City	:	DAWSONVILLE
State	:	GA
Zip	:	30534-5334
Country	:	US
Telephone Number	:	706-265-4664
Fax Number	:	770-534-2093

Provider Business Practice Location Address
First Line	:	5304 THOMPSON BRIDGE RD
Second Line	:
City	:	MURRAYVILLE
State	:	GA
Zip	:	30564-1941
Country	:	US
Telephone Number	:	770-534-2245
Fax Number	:	770-534-2093

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

Provider Enumeration Date	:	11/17/2006
Last Update Date	:	07/08/2007

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Directions to “ LINDA P BEARDEN ” Practice Location

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