James Harworth Beale, RPH

Individual provider Active NPI Pharmacist · Waycross, GA

NPI 1295837052 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1295837052
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
14779 (GA)
Practice address
1710 Alice St
Waycross, GA 31501-5216
Phone
(912) 283-1151
Fax
(912) 283-9797
NPI assigned
Sep 2, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
14779GAMDStudent in an Organized Health Care Education/Training Program

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 14779 GA Yes

Addresses

Primary practice location

1710 Alice St
Waycross, GA 31501-5216

Mailing address

4040 Pinecrest Rd
Waycross, GA 31503-9576
Phone (912) 285-5473

Other providers in Waycross, GA

All providers in Waycross, GA · Pharmacist in Georgia

Sources for this page

Verify at the official NPI Registry.