Individual
STEPHEN BEALS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2900 DOOLITTLE DR, ELLSWORTH AFB, SD 57706-4821
(605) 385-3202
Mailing address
2900 DOOLITTLE DR, ELLSWORTH AFB, SD 57706-4821
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
4862
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4082
REGISTERED PHARMACIST
SD
Enumeration date
04/12/2018
Last updated
10/19/2020
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