Provider Demographics
NPI:1114060555
Name:BEANE, DARLA D (RPH)
Entity Type:Individual
Prefix:
First Name:DARLA
Middle Name:D
Last Name:BEANE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 81 BOX 106A
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:WV
Mailing Address - Zip Code:24901-9528
Mailing Address - Country:US
Mailing Address - Phone:304-645-4287
Mailing Address - Fax:304-645-1891
Practice Address - Street 1:370 SENECA TRL
Practice Address - Street 2:
Practice Address - City:RONCEVERTE
Practice Address - State:WV
Practice Address - Zip Code:24970-1340
Practice Address - Country:US
Practice Address - Phone:304-645-1892
Practice Address - Fax:304-645-1891
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0006238183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist