Individual
EVAN BEAKAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3701 PORTAGE AVE, SOUTH BEND, IN 46628-6098
(574) 243-4915
Mailing address
PO BOX 438, NEW CARLISLE, IN 46552-0438
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26027612A
IN
Other
Enumeration date
02/02/2022
Last updated
02/02/2022
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