Provider Demographics
NPI:1477829109
Name:BIH, BEACKY
Entity Type:Individual
Prefix:
First Name:BEACKY
Middle Name:
Last Name:BIH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30283 TRIANGLE DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE HALL
Mailing Address - State:MD
Mailing Address - Zip Code:20622-3125
Mailing Address - Country:US
Mailing Address - Phone:301-472-1825
Mailing Address - Fax:301-472-1867
Practice Address - Street 1:7600 GEORGIA AVE NW
Practice Address - Street 2:SUITE 323
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20012-1616
Practice Address - Country:US
Practice Address - Phone:202-723-3060
Practice Address - Fax:202-723-3065
Is Sole Proprietor?:No
Enumeration Date:2012-03-27
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374U00000X
MD28509183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No374U00000XNursing Service Related ProvidersHome Health Aide