Healthcare Provider Details

I. General information

NPI: 1326012543
Provider Name (Legal Business Name): BENMED INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2006
Last Update Date: 12/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1408 W BROAD ST STE 2
QUAKERTOWN PA
18951-1193
US

IV. Provider business mailing address

1408 W BROAD ST STE 2
QUAKERTOWN PA
18951-1193
US

V. Phone/Fax

Practice location:
  • Phone: 215-536-5595
  • Fax: 215-536-6426
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPP414874L
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier3968243
Identifier TypeOTHER
Identifier State
Identifier IssuerNCPDP PROVIDER IDENTIFICATION NUMBER
# 2
Identifier001455604
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer

VIII. Authorized Official

Name: PHILLIP BENNETT
Title or Position: OWNER/PHARMACIST
Credential: BS PHARM/BIO
Phone: 215-536-5595