Provider Demographics
NPI:1104161710
Name:BEASLEY DRUG COMPANY
Entity type:Organization
Organization Name:BEASLEY DRUG COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ORA
Authorized Official - Middle Name:J
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:770-483-7211
Mailing Address - Street 1:933 CENTER ST NE
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30012-4567
Mailing Address - Country:US
Mailing Address - Phone:770-483-7211
Mailing Address - Fax:770-483-9654
Practice Address - Street 1:933 CENTER ST NE
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30012-4567
Practice Address - Country:US
Practice Address - Phone:770-483-7211
Practice Address - Fax:770-483-9654
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-07
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy