Basic Information
| Provider Information | |||||||||
| NPI: | 1770199457 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BEACH | ||||||||
| FirstName: | KATHERINE | ||||||||
| MiddleName: | FRANCES | ||||||||
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| Credential: | PHARMD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 600 HIGHLAND AVENUE | ||||||||
| Address2: | DEPARTMENT OF PHARMACY | ||||||||
| City: | MADISON | ||||||||
| State: | WI | ||||||||
| PostalCode: | 53792 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 600 HIGHLAND AVENUE | ||||||||
| Address2: | DEPARTMENT OF PHARMACY | ||||||||
| City: | MADISON | ||||||||
| State: | WI | ||||||||
| PostalCode: | 53792 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6082636400 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/18/2020 | ||||||||
| LastUpdateDate: | 09/18/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/18/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 19269-40 | WI | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.