Provider Demographics
NPI:1679677363
Name:BEACH, LAUREN POMEROY (RD)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:POMEROY
Last Name:BEACH
Suffix:
Gender:F
Credentials:RD
Other - Prefix:MISS
Other - First Name:LAUREN
Other - Middle Name:EDDY
Other - Last Name:POMEROY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:623 S MASON ST
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-3211
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:235 CANTRELL AVE
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-3248
Practice Address - Country:US
Practice Address - Phone:540-564-7044
Practice Address - Fax:540-564-5639
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered