Provider Demographics
NPI:1780038570
Name:PHARMACY SERVICE INC.
Entity Type:Organization
Organization Name:PHARMACY SERVICE INC.
Other - Org Name:BEEMANS PRESCRIPTION PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:BEEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:909-882-3719
Mailing Address - Street 1:355 E 21ST ST
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92404-4824
Mailing Address - Country:US
Mailing Address - Phone:909-882-3719
Mailing Address - Fax:909-881-2390
Practice Address - Street 1:355 E 21ST ST
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92404-4824
Practice Address - Country:US
Practice Address - Phone:909-882-3719
Practice Address - Fax:909-881-2390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-18
Last Update Date:2016-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45444183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA45444OtherREGISTERED PHARMACIST LICENSE