Provider Demographics
NPI:1518215052
Name:BEACH, JAMES RICHEY (LICENSED DISPENSING)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:RICHEY
Last Name:BEACH
Suffix:
Gender:M
Credentials:LICENSED DISPENSING
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4833 WESTCHESTER DRIVE
Mailing Address - Street 2:APT. 118
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515-2542
Mailing Address - Country:US
Mailing Address - Phone:330-503-8675
Mailing Address - Fax:330-799-4515
Practice Address - Street 1:4833 WESTCHESTER DRIVE
Practice Address - Street 2:APT. 118
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44515-2542
Practice Address - Country:US
Practice Address - Phone:330-503-8675
Practice Address - Fax:330-799-4515
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-15
Last Update Date:2012-08-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH4514SC332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies