Provider Demographics
NPI:1780223602
Name:O'HARROW-BEVANS, JOAN M (BS PHARMACY)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:M
Last Name:O'HARROW-BEVANS
Suffix:
Gender:F
Credentials:BS PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:279 COLLINS RD NE
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-3163
Mailing Address - Country:US
Mailing Address - Phone:319-393-4480
Mailing Address - Fax:319-393-5860
Practice Address - Street 1:279 COLLINS RD NE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-3163
Practice Address - Country:US
Practice Address - Phone:319-393-4480
Practice Address - Fax:319-393-5860
Is Sole Proprietor?:No
Enumeration Date:2019-12-23
Last Update Date:2019-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA18053183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist