Provider Demographics
NPI:1902566045
Name:BEALL, TERRIL DAVID (PHARMD)
Entity Type:Individual
Prefix:
First Name:TERRIL
Middle Name:DAVID
Last Name:BEALL
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:PO BOX 94805
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72190-4805
Mailing Address - Country:US
Mailing Address - Phone:501-837-8702
Mailing Address - Fax:
Practice Address - Street 1:4823 JFK BLVD
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72116-7314
Practice Address - Country:US
Practice Address - Phone:501-771-1971
Practice Address - Fax:501-791-7046
Is Sole Proprietor?:No
Enumeration Date:2021-12-29
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD07426183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist