Provider Demographics
NPI:1972817047
Name:SCHNICK, BEVERLY (RPH)
Entity Type:Individual
Prefix:MRS
First Name:BEVERLY
Middle Name:
Last Name:SCHNICK
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 FAIRVIEW DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27292-5332
Mailing Address - Country:US
Mailing Address - Phone:336-224-0424
Mailing Address - Fax:336-224-0434
Practice Address - Street 1:1250 FAIRVIEW DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:NC
Practice Address - Zip Code:27292-5332
Practice Address - Country:US
Practice Address - Phone:336-224-0424
Practice Address - Fax:336-224-0434
Is Sole Proprietor?:No
Enumeration Date:2010-08-01
Last Update Date:2010-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC110321835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0295913Medicaid