Provider Demographics
NPI:1003458985
Name:BEEMER, BRENT DOUGLAS (PHARM D)
Entity Type:Individual
Prefix:
First Name:BRENT
Middle Name:DOUGLAS
Last Name:BEEMER
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10075 BUCHANAN RD
Mailing Address - Street 2:
Mailing Address - City:STANWOOD
Mailing Address - State:MI
Mailing Address - Zip Code:49346-9762
Mailing Address - Country:US
Mailing Address - Phone:231-359-1661
Mailing Address - Fax:231-359-1665
Practice Address - Street 1:10075 BUCHANAN RD
Practice Address - Street 2:
Practice Address - City:STANWOOD
Practice Address - State:MI
Practice Address - Zip Code:49346-9762
Practice Address - Country:US
Practice Address - Phone:231-359-1661
Practice Address - Fax:231-359-1665
Is Sole Proprietor?:No
Enumeration Date:2019-10-12
Last Update Date:2019-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302037969183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist