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General NPI Number Information
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NPI Number | 1588721682
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Entity Type | Organization
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Legal Business Name | THE DRUG STORE BENTON LLC
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Dates
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Enumeration Date | 01/02/2007
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Last Update Date | 10/16/2025
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Provider Practice Location Address
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Address Line | 119 MAIN ST
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City | BENTON
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State | TN
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Zip | 37307-3864
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Country | US
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Telephone | 423-338-2521
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Fax | 423-338-1092
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Provider Business Mailing Address
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Address Line | 119 MAIN ST P.O.BOX 127
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City | BENTON
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State | TN
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Zip | 37307-3864
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Country | US
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Telephone | 423-338-2521
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Fax | 423-338-1092
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | RACHEL M BREWER
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Credential | PHARMD
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Telephone | 423-338-2521
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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 | 1328
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License Number State | TN
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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 | 25571
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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