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NPI Code Detail

MEDICARE: MS. SHELLEY GRACE BENSON R.PH.

MEDICARE: MS. SHELLEY GRACE BENSON R.PH.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11835X0200XOncology Pharmacist3177NH

General Provider Information

NPI Number : 1003026360
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SHELLEY GRACE BENSON R.PH.
Provider Business Mailing Address
First Line : 667 RIDGE RD
Second Line :
City : RANDOLPH CENTER
State : VT
Zip : 05061-9748
Country : US
Telephone Number : 802-728-6382
Fax Number :
Provider Business Practice Location Address
First Line : 1 MEDICAL CENTER DR
Second Line :
City : LEBANON
State : NH
Zip : 03756-1000
Country : US
Telephone Number : 603-650-5417
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2007
Last Update Date : 07/08/2007

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Directions to “ MS. SHELLEY GRACE BENSON R.PH.” Practice Location

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