Provider Demographics
NPI:1386633006
Name:BEANE, CHAD ERIC (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:CHAD
Middle Name:ERIC
Last Name:BEANE
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 AUDREY LN
Mailing Address - Street 2:
Mailing Address - City:LACONIA
Mailing Address - State:NH
Mailing Address - Zip Code:03246-3065
Mailing Address - Country:US
Mailing Address - Phone:603-528-6008
Mailing Address - Fax:
Practice Address - Street 1:1400 LAKE SHORE RD
Practice Address - Street 2:
Practice Address - City:GILFORD
Practice Address - State:NH
Practice Address - Zip Code:03249-2249
Practice Address - Country:US
Practice Address - Phone:603-524-5240
Practice Address - Fax:603-528-8063
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3184183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist