Basic Information
| Provider Information | |||||||||
| NPI: | 1114060555 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BEANE | ||||||||
| FirstName: | DARLA | ||||||||
| MiddleName: | D | ||||||||
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| Credential: | R.PH | ||||||||
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| Mailing Information | |||||||||
| Address1: | HC 81 BOX 106A | ||||||||
| Address2: | |||||||||
| City: | LEWISBURG | ||||||||
| State: | WV | ||||||||
| PostalCode: | 249019528 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3046454287 | ||||||||
| FaxNumber: | 3046451891 | ||||||||
| Practice Location | |||||||||
| Address1: | 370 SENECA TRL | ||||||||
| Address2: | |||||||||
| City: | RONCEVERTE | ||||||||
| State: | WV | ||||||||
| PostalCode: | 249701340 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3046451892 | ||||||||
| FaxNumber: | 3046451891 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/15/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | RP0006238 | WV | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.