Walter Ballard Beaven
Pharmacist in Louisville, KY. Individual provider (NPI-1).
NPI number1336765684
StatusActive
Last updated in NPPESJun 23, 2020
Details
- NPI
- 1336765684
- Entity type
- Individual (NPI-1)
- Name
- Walter Ballard Beaven
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 23, 2020
- Certification date
- Jun 23, 2020
- Last updated
- Jun 23, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 183500000X | Pharmacist | 9049 | KY | Yes |
Practice location
12611 Taylorsville RdLouisville, KY 40299-4452
Phone 502-261-7042 · Fax 502-266-2616
Mailing address
17006 Persimmon Wood TrlFisherville, KY 40023-9706
Phone 502-424-3448
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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