Terrell Beavers, P.D.
Individual provider Active NPI Pharmacist · Rogers, AR
NPI 1699072298 · NPPES record last updated Feb 16, 2011
Key facts
- NPI
- 1699072298
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- PD6543 (AR)
- Practice address
- 5745 Chanberry LN
Rogers, AR 72758-8673 - Phone
- (870) 623-0718
- NPI assigned
- Feb 16, 2011
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PD6543 | AR | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PD6543 | AR | Yes |
Addresses
Primary practice location
5745 Chanberry LN
Rogers, AR 72758-8673
Mailing address
5745 Chanberry LN
Rogers, AR 72758-8673
Phone (870) 623-0718
Other providers in Rogers, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 16, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.