Provider Demographics
NPI:1336840396
Name:BEAM, TYLER MAX (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TYLER
Middle Name:MAX
Last Name:BEAM
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 FISHER RD
Mailing Address - Street 2:
Mailing Address - City:CHERRYVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28021-9552
Mailing Address - Country:US
Mailing Address - Phone:704-616-4698
Mailing Address - Fax:
Practice Address - Street 1:200 S POST RD
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28152-6269
Practice Address - Country:US
Practice Address - Phone:980-484-5306
Practice Address - Fax:800-865-4512
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-15
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC21706183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist