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General NPI Number Information
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NPI Number | 1730692377
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Entity Type | Organization
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Legal Business Name | BENZER PHARMACY
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Dates
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Enumeration Date | 11/06/2017
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Last Update Date | 08/24/2018
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Provider Practice Location Address
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Address Line | 150 S HOUSTON LAKE RD STE 300
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City | WARNER ROBINS
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State | GA
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Zip | 31088
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Country | US
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Telephone | 478-335-0756
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Fax |
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Provider Business Mailing Address
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Address Line | 150 S HOUSTON LAKE RD STE 300
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City | WARNER ROBINS
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State | GA
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Zip | 31088-9056
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Country | US
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Telephone | 478-335-0756
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANKIT PATEL
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Credential |
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Telephone | 478-333-6767
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHRE01041
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License Number State | GA
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