Provider Demographics
NPI:1881239846
Name:BEESON, ERIC TODD (PHARMD)
Entity type:Individual
Prefix:MR
First Name:ERIC
Middle Name:TODD
Last Name:BEESON
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 1:7 SUMMERS RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26508-1133
Mailing Address - Country:US
Mailing Address - Phone:304-476-2275
Mailing Address - Fax:
Practice Address - Street 1:75 RETAIL CIR
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26508-1646
Practice Address - Country:US
Practice Address - Phone:304-292-9887
Practice Address - Fax:304-292-9889
Is Sole Proprietor?:No
Enumeration Date:2019-11-14
Last Update Date:2019-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0007577183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist