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General NPI Number Information
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NPI Number | 1659598753
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Entity Type | Organization
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Legal Business Name | BENZER IL 1 LLC
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 01/29/2019
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Provider Practice Location Address
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Address Line | 2024 W. 79TH STREET
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City | CHICAGO
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State | IL
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Zip | 60620
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Country | US
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Telephone | 773-994-2845
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Fax | 773-482-2008
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Provider Business Mailing Address
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Address Line | 5908 BRECKENRIDGE PARKWAY
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City | TAMPA
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State | FL
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Zip | 33610
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Country | US
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Telephone | 813-304-2221
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Fax | 888-239-8423
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Authorized Official
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Title or Position | OWNER
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Name | ALPESH PATEL
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Credential |
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Telephone | 813-304-2221
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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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 | 054.009724
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License Number State | IL
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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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