Provider Demographics
NPI:1417685306
Name:BEAM BEAM AND MOSS INC
Entity Type:Organization
Organization Name:BEAM BEAM AND MOSS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DME
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:S
Authorized Official - Last Name:HASTINGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-435-6011
Mailing Address - Street 1:302 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CHERRYVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28021-3411
Mailing Address - Country:US
Mailing Address - Phone:704-435-4601
Mailing Address - Fax:704-445-1528
Practice Address - Street 1:302 E MAIN ST
Practice Address - Street 2:
Practice Address - City:CHERRYVILLE
Practice Address - State:NC
Practice Address - Zip Code:28021-3411
Practice Address - Country:US
Practice Address - Phone:704-435-6011
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-10
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy