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General NPI Number Information
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NPI Number | 1790052975
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Entity Type | Individual
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Provider Name | BENJAMIN GENARO RPH.
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Gender | Male
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Dates
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Enumeration Date | 11/16/2011
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Last Update Date | 09/14/2021
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Provider Practice Location Address
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Address Line | 3716 MELROSE AVE NW
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City | ROANOKE
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State | VA
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Zip | 24017-2716
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Country | US
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Telephone | 540-283-2552
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Fax | 540-283-2544
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Provider Business Mailing Address
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Address Line | 2032 BRIDGEPORT LN
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City | ROANOKE
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State | VA
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Zip | 24012-6783
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Country | US
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Telephone | 540-840-2279
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Fax | 540-283-2544
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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 | RP038984L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 0202011488
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License Number State | VA
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