Provider Demographics
NPI:1073000881
Name:BEACH RX, INC
Entity Type:Organization
Organization Name:BEACH RX, INC
Other - Org Name:BEACH PHARMACY OF HATTERAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:THORNBROUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-986-2400
Mailing Address - Street 1:PO BOX 428
Mailing Address - Street 2:
Mailing Address - City:HATTERAS
Mailing Address - State:NC
Mailing Address - Zip Code:27943-0428
Mailing Address - Country:US
Mailing Address - Phone:252-986-2400
Mailing Address - Fax:252-986-5363
Practice Address - Street 1:57353 NE HWY 12
Practice Address - Street 2:
Practice Address - City:HATTERAS
Practice Address - State:NC
Practice Address - Zip Code:27943
Practice Address - Country:US
Practice Address - Phone:252-986-2400
Practice Address - Fax:252-986-2905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-17
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC27127183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty