Provider Demographics
NPI:1982264123
Name:BEEBE, DANIEL LOREN (RPH)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:LOREN
Last Name:BEEBE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:716 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:41011-2412
Mailing Address - Country:US
Mailing Address - Phone:859-431-2857
Mailing Address - Fax:859-291-1900
Practice Address - Street 1:716 MADISON AVE
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:KY
Practice Address - Zip Code:41011-2412
Practice Address - Country:US
Practice Address - Phone:859-431-2857
Practice Address - Fax:859-291-1900
Is Sole Proprietor?:No
Enumeration Date:2019-06-19
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY010227183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist