Provider Demographics
NPI:1851723688
Name:BEELER, BRANDON DALE (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:DALE
Last Name:BEELER
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:661 MIRANDA ST # A
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81505-7014
Mailing Address - Country:US
Mailing Address - Phone:269-270-2211
Mailing Address - Fax:
Practice Address - Street 1:2900 NORTH AVE
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81504-5315
Practice Address - Country:US
Practice Address - Phone:970-208-1014
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-02
Last Update Date:2013-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0019943183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist