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General NPI Number Information
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NPI Number | 1215942693
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Entity Type | Organization
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Legal Business Name | BEN'S PHARMACY LLC
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Dates
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Enumeration Date | 07/31/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4734 BROADWAY
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City | NEW YORK
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State | NY
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Zip | 10040-1103
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Country | US
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Telephone | 212-304-4712
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Fax |
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Provider Business Mailing Address
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Address Line | 436 FORT WASHINGTON AVE # 3E
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City | NEW YORK
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State | NY
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Zip | 10033-3507
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | MARK FARD
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Credential |
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Telephone | 212-795-6791
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 027928
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License Number State | NY
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