Provider Demographics
NPI:1740882042
Name:BEARDSLEY, EMILY LAUREN
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:LAUREN
Last Name:BEARDSLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 W SPROUL RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:19064-1215
Mailing Address - Country:US
Mailing Address - Phone:610-328-0033
Mailing Address - Fax:
Practice Address - Street 1:721 W SPROUL RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:PA
Practice Address - Zip Code:19064-1215
Practice Address - Country:US
Practice Address - Phone:610-328-0033
Practice Address - Fax:610-328-0043
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-11
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP453075183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist