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General NPI Number Information
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NPI Number | 1821106287
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Entity Type | Organization
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Legal Business Name | BENSON DRUG COMPANY INC.
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Dates
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Enumeration Date | 08/27/2006
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Last Update Date | 08/02/2019
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Provider Practice Location Address
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Address Line | 961 SPRING ST
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City | MUSKEGON
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State | MI
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Zip | 49442-3278
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Country | US
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Telephone | 231-722-2861
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Fax | 231-726-5522
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Provider Business Mailing Address
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Address Line | 961 SPRING ST
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City | MUSKEGON
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State | MI
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Zip | 49442-3278
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Country | US
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Telephone | 231-722-2861
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Fax | 231-726-5522
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Authorized Official
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Title or Position | PRESIDENT
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Name | RANDOLPH BENSON DAHLQUIST
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Credential | R.PH.
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Telephone | 231-722-2861
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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 | 5301000892
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License Number State | MI
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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 |
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License Number State | MI
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