=====================================================
General NPI Number Information
=====================================================
NPI Number | 1750423810
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BENNETT PHARMACY INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/13/2007
-----------------------------------------------------
Last Update Date | 04/23/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1 W MAIN ST
-----------------------------------------------------
City | NEW HAMPTON
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 50659-2101
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 641-394-4156
-----------------------------------------------------
Fax | 641-394-4155
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 250 S LINN AVE
-----------------------------------------------------
City | NEW HAMPTON
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 50659-2020
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 641-394-4156
-----------------------------------------------------
Fax | 641-394-4155
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PARTNER
-----------------------------------------------------
Name | DR. MICHAEL JOSEPH DENINGER
-----------------------------------------------------
Credential | PH.D.
-----------------------------------------------------
Telephone | 319-337-3526
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 13531
-----------------------------------------------------
License Number State | IA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------