Healthcare Provider Details

I. General information

NPI: 1063806800
Provider Name (Legal Business Name): BENGY MITCHELL PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/18/2015
Last Update Date: 03/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 TRI COUNTY PKWY
CINCINNATI OH
45246-3217
US

IV. Provider business mailing address

150 TRI COUNTY PKWY
CINCINNATI OH
45246-3217
US

V. Phone/Fax

Practice location:
  • Phone: 513-782-3384
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03223374
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: