Provider Demographics
NPI:1922368000
Name:BEIRISE, NEAL STEVEN (RPH)
Entity type:Individual
Prefix:
First Name:NEAL
Middle Name:STEVEN
Last Name:BEIRISE
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 1:813 NOBLES MILL RD
Mailing Address - Street 2:
Mailing Address - City:DEEP RUN
Mailing Address - State:NC
Mailing Address - Zip Code:28525-9697
Mailing Address - Country:US
Mailing Address - Phone:252-568-6455
Mailing Address - Fax:
Practice Address - Street 1:1302 W VERNON AVE
Practice Address - Street 2:
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28504-3528
Practice Address - Country:US
Practice Address - Phone:282-523-6069
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-22
Last Update Date:2012-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11533183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist