Provider Demographics
NPI:1750985826
Name:BEFFORD, MIKAYLA ANN (PHARMD)
Entity type:Individual
Prefix:
First Name:MIKAYLA
Middle Name:ANN
Last Name:BEFFORD
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 RESERVOIR ST
Mailing Address - Street 2:
Mailing Address - City:HOLDEN
Mailing Address - State:MA
Mailing Address - Zip Code:01520-1270
Mailing Address - Country:US
Mailing Address - Phone:508-829-7631
Mailing Address - Fax:
Practice Address - Street 1:160 RESERVOIR ST
Practice Address - Street 2:
Practice Address - City:HOLDEN
Practice Address - State:MA
Practice Address - Zip Code:01520-1270
Practice Address - Country:US
Practice Address - Phone:508-829-7631
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-29
Last Update Date:2020-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH238229183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist