Provider Demographics
NPI:1982846994
Name:BEAT, ROBERT DERRILL (PHARM)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:DERRILL
Last Name:BEAT
Suffix:
Gender:M
Credentials:PHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4909 WILLOW DR
Mailing Address - Street 2:
Mailing Address - City:ELIDA
Mailing Address - State:OH
Mailing Address - Zip Code:45807-1331
Mailing Address - Country:US
Mailing Address - Phone:419-339-1586
Mailing Address - Fax:
Practice Address - Street 1:4909 WILLOW DR
Practice Address - Street 2:
Practice Address - City:ELIDA
Practice Address - State:OH
Practice Address - Zip Code:45807-1331
Practice Address - Country:US
Practice Address - Phone:419-339-1586
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-06
Last Update Date:2009-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03309803183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist