Provider Demographics
NPI:1730291436
Name:BEELERS DRUGSTORE
Entity Type:Organization
Organization Name:BEELERS DRUGSTORE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:BEELER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:502-833-4831
Mailing Address - Street 1:PO BOX 489
Mailing Address - Street 2:
Mailing Address - City:LEBANON JUNCTION
Mailing Address - State:KY
Mailing Address - Zip Code:40150-0489
Mailing Address - Country:US
Mailing Address - Phone:502-833-4831
Mailing Address - Fax:502-833-4586
Practice Address - Street 1:11715 S PRESTON HWY
Practice Address - Street 2:
Practice Address - City:LEBANON JUNCTION
Practice Address - State:KY
Practice Address - Zip Code:40150-8413
Practice Address - Country:US
Practice Address - Phone:502-833-4831
Practice Address - Fax:502-833-4586
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYP00816183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1805689OtherNABP
KY54011065Medicaid