Provider Demographics
NPI:1710317987
Name:BEACOM PHARMACY INC
Entity Type:Organization
Organization Name:BEACOM PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MIGUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:TEJERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-324-6500
Mailing Address - Street 1:752 W FLAGLER ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33130-1248
Mailing Address - Country:US
Mailing Address - Phone:305-324-6500
Mailing Address - Fax:305-324-6520
Practice Address - Street 1:752 W FLAGLER ST
Practice Address - Street 2:SUITE 101
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33130-1248
Practice Address - Country:US
Practice Address - Phone:305-324-6500
Practice Address - Fax:305-324-6520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-25
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH272213336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy