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NPI Code Detail

MEDICARE: DR. JILL R BENNETT PHARMD

MEDICARE: DR. JILL R BENNETT PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11835P1200XPharmacotherapy Pharmacist13711WI
21835P1200XPharmacotherapy Pharmacist19770IA

General Provider Information

NPI Number : 1679650881
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JILL R BENNETT PHARMD
Provider Business Mailing Address
First Line : 617 MCLEAN DR
Second Line :
City : MADISON
State : WI
Zip : 53718-3091
Country : US
Telephone Number : 608-230-6408
Fax Number :
Provider Business Practice Location Address
First Line : UNIVERSITY OF WISCONSIN HOSPITAL
Second Line : 600 HIGHLAND AVE F6/133-1530
City : MADISON
State : WI
Zip : 53792-0001
Country : US
Telephone Number : 608-263-1290
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2006
Last Update Date : 07/08/2007

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