Provider Demographics
NPI:1972895589
Name:STRAUSS, BETH EILEEN (RPH)
Entity type:Individual
Prefix:MRS
First Name:BETH
Middle Name:EILEEN
Last Name:STRAUSS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 S COLLEGE RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-4410
Mailing Address - Country:US
Mailing Address - Phone:910-395-9312
Mailing Address - Fax:910-799-5102
Practice Address - Street 1:820 S COLLEGE RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-4410
Practice Address - Country:US
Practice Address - Phone:910-395-9312
Practice Address - Fax:910-799-5102
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-15
Last Update Date:2011-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC13250183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0655860Medicaid