Organization
BEACH PHARMACY INC
Active
Other names
BEACH PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY KROHN RPH (PRESIDENT)
(228) 896-7070
Entity
Organization
Contact information
Practice address
1110 COWAN RD, GULFPORT, MS 39507-3441
(228) 896-7070
(228) 896-2843
Mailing address
1110 COWAN RD, GULFPORT, MS 39507-3441
(228) 896-7070
(228) 896-2843
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
0043711
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00030252
—
MS
01
—
2043214
PK
—
Enumeration date
12/26/2006
Last updated
04/29/2016
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