Provider Demographics
NPI:1871639690
Name:BEALLS PHARMACY INC. PS
Entity Type:Organization
Organization Name:BEALLS PHARMACY INC. PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:NORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:253-845-8444
Mailing Address - Street 1:110 W MEEKER
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98371-5384
Mailing Address - Country:US
Mailing Address - Phone:253-845-8444
Mailing Address - Fax:253-845-7114
Practice Address - Street 1:110 W MEEKER
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98371-5384
Practice Address - Country:US
Practice Address - Phone:253-845-8444
Practice Address - Fax:253-845-7114
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BEALLS PHARMACY INC. PS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-29
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACF00004142183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty