1013223288 NPI number — BECKET ACADEMY, INC.

Table of content: DR. JOSHUA DAVID BEACH PHARM.D. (NPI 1013263185)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013223288 NPI number — BECKET ACADEMY, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BECKET ACADEMY, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1013223288
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/13/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 325
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ORFORD
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03777-0325
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-353-9102
Provider Business Mailing Address Fax Number:
603-353-9412

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
47 POND RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEWISTON
Provider Business Practice Location Address State Name:
ME
Provider Business Practice Location Address Postal Code:
04240-1608
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
207-241-7552
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/26/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
PIKE
Authorized Official First Name:
ERIKA
Authorized Official Middle Name:
Authorized Official Title or Position:
AR COORDINATOR
Authorized Official Telephone Number:
603-353-9102

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , registered in the state of ME ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)