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General NPI Number Information
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NPI Number | 1346535101
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Entity Type | Individual
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Provider Name | ANDREA NEILL BENSON RPH
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Gender | Female
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Dates
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Enumeration Date | 06/09/2011
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Last Update Date | 06/09/2011
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Provider Practice Location Address
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Address Line | 1475 N EXPRESSWAY
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City | GRIFFIN
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State | GA
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Zip | 30223-1776
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Country | US
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Telephone | 770-228-4426
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Fax | 770-228-2307
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Provider Business Mailing Address
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Address Line | 135 LOUMAE RD
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City | GRIFFIN
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State | GA
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Zip | 30224-5137
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Country | US
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Telephone | 678-688-5588
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Fax | 770-228-2307
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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 | RPH021486
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License Number State | GA
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