Provider Demographics
NPI:1427048958
Name:BEAVER, DENNIS CLIFFORD (RPH)
Entity type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:CLIFFORD
Last Name:BEAVER
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 1:521 NORTHFIELD DR
Mailing Address - Street 2:
Mailing Address - City:CIRCLEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43113-1162
Mailing Address - Country:US
Mailing Address - Phone:740-474-4977
Mailing Address - Fax:740-983-2503
Practice Address - Street 1:4 MAIN ST E
Practice Address - Street 2:
Practice Address - City:ASHVILLE
Practice Address - State:OH
Practice Address - Zip Code:43103-1512
Practice Address - Country:US
Practice Address - Phone:740-983-2501
Practice Address - Fax:740-983-2503
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-2-13124183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist