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General NPI Number Information
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NPI Number | 1659389864
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Entity Type | Organization
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Legal Business Name | BENTON DISCOUNT PHARMACY INC
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Dates
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Enumeration Date | 08/03/2006
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Last Update Date | 12/19/2023
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Provider Practice Location Address
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Address Line | 153 US HIGHWAY 68 E
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City | BENTON
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State | KY
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Zip | 42025-7123
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Country | US
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Telephone | 270-527-1404
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Fax |
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Provider Business Mailing Address
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Address Line | 153 US HIGHWAY 68 E
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City | BENTON
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State | KY
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Zip | 42025-7123
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Country | US
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Telephone | 270-527-1404
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | MORGAN BECK
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Credential | RPH
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Telephone | 270-527-1404
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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 | P02124
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | P02124
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License Number State | KY
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