Provider Demographics
NPI:1316532393
Name:BEECHER, PAUL ANDREW (PHARMD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:ANDREW
Last Name:BEECHER
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 1:410 WELLGREEN DR
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30115-5563
Mailing Address - Country:US
Mailing Address - Phone:912-704-1548
Mailing Address - Fax:
Practice Address - Street 1:1100 WILSON WAY SE
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30082-7248
Practice Address - Country:US
Practice Address - Phone:912-704-1548
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-02
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH031276183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist