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General NPI Number Information
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NPI Number | 1710583802
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Entity Type | Individual
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Provider Name | MADELINE CADLE BENNETT PHARMD
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Gender | Female
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Dates
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Enumeration Date | 12/05/2020
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Last Update Date | 06/12/2023
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Provider Practice Location Address
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Address Line | 1213 SKYLINE DR
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City | HOPKINSVILLE
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State | KY
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Zip | 42240-4986
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Country | US
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Telephone | 270-886-4594
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Fax |
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Provider Business Mailing Address
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Address Line | 701 NW SHERIDAN RD
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City | LAWTON
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State | OK
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Zip | 73505-5202
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Country | US
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Telephone | 580-353-3948
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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 | 19025
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 023396
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License Number State | KY
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