Provider Demographics
NPI:1427365691
Name:NORTH BEACH ENTERPRISES, INC.
Entity Type:Organization
Organization Name:NORTH BEACH ENTERPRISES, INC.
Other - Org Name:BEACH PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST/ PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHARLOTTE
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:KILGORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-965-3036
Mailing Address - Street 1:3198 PACIFIC AVE
Mailing Address - Street 2:SUITE 124
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23451-2949
Mailing Address - Country:US
Mailing Address - Phone:757-965-3036
Mailing Address - Fax:757-965-3039
Practice Address - Street 1:3198 PACIFIC AVE
Practice Address - Street 2:SUITE 124
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23451-2949
Practice Address - Country:US
Practice Address - Phone:757-965-3036
Practice Address - Fax:757-965-3039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-08
Last Update Date:2016-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy