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General NPI Number Information
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NPI Number | 1245572098
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Entity Type | Individual
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Provider Name | BENJAMIN REID ALLEN PHARMD
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Gender | Male
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Dates
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Enumeration Date | 03/20/2013
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Last Update Date | 03/20/2013
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Provider Practice Location Address
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Address Line | 1542 WAYNE AVE
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City | DAYTON
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State | OH
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Zip | 45410-1708
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Country | US
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Telephone | 937-254-2156
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Fax |
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Provider Business Mailing Address
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Address Line | 13028 TONKEL RD
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City | FORT WAYNE
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State | IN
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Zip | 46845-9226
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Country | US
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Telephone | 260-403-8855
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 03132508
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 26024904A
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License Number State | IN
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