Provider Demographics
NPI:1235457284
Name:BEAN, RAND W (RPH)
Entity Type:Individual
Prefix:
First Name:RAND
Middle Name:W
Last Name:BEAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 COFFEETOWN RD
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD
Mailing Address - State:NH
Mailing Address - Zip Code:03037-1218
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:56 CALEF HWY
Practice Address - Street 2:
Practice Address - City:LEE
Practice Address - State:NH
Practice Address - Zip Code:03861-6701
Practice Address - Country:US
Practice Address - Phone:603-868-6404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-13
Last Update Date:2010-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2231183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH2231OtherNH RPH LICENSE