Organization
JONATHAN BEASLEY PHARMACY INC
Active
Other names
Beasley's Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN BEASLEY (OWNER)
(205) 695-0144
Entity
Organization
Contact information
Practice address
170 5TH ST SW, VERNON, AL 35592-5215
(205) 695-0144
(205) 695-0139
Mailing address
PO BOX 456, VERNON, AL 35592-0456
(205) 695-0144
(205) 695-0139
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
114683
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
196440
—
AL
01
—
2167011
PK
—
Enumeration date
12/16/2016
Last updated
04/24/2017
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