Beacon Professional Pharmacy, Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

BEACON PROFESSIONAL PHARMACY, INC

Practice address

23350 Greenfield Rd
Oak Park, MI 48237-2496

Phone

(248) 968-3800

Fax

(248) 968-3801

NPI assigned

Sep 20, 2012

Last updated

Mar 15, 2013By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Rene A Eid, RPH

Title

Owner

Phone

(586) 909-4964

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1348099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363305600000",
    "number": "1114278926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54876 ALEXIS CT",
            "city": "SHELBY TWP",
            "state": "MI",
            "postal_code": "483161359",
            "telephone_number": "586-909-4964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23350 GREENFIELD RD",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482372496",
            "telephone_number": "248-968-3800",
            "fax_number": "248-968-3801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACON PROFESSIONAL PHARMACY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-20",
        "last_updated": "2013-03-15",
        "status": "A",
        "authorized_official_last_name": "EID",
        "authorized_official_first_name": "RENE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "586-909-4964",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.