Provider Demographics
NPI:1790918936
Name:BEAMER PHARMACY LLC
Entity Type:Organization
Organization Name:BEAMER PHARMACY LLC
Other - Org Name:BEAMER PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:NEERA
Authorized Official - Middle Name:
Authorized Official - Last Name:PATIDAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-484-0022
Mailing Address - Street 1:13630 BEAMER RD STE 103
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77089-6037
Mailing Address - Country:US
Mailing Address - Phone:281-484-0022
Mailing Address - Fax:
Practice Address - Street 1:13630 BEAMER RD STE 103
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77089-6037
Practice Address - Country:US
Practice Address - Phone:281-484-0022
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-03
Last Update Date:2009-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX266073336C0003X
3336C0004X, 3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4553841OtherNCPDP PROVIDER IDENTIFICATION NUMBER