MEDICARE: BENETS PHARMACIES INC.

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
1	3336C0003X	Community/Retail Pharmacy	02-0123000	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1230	OTHER	OH	PIN
2	3600423	OTHER	OH	NCPDP
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124087762
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BENETS PHARMACIES INC.

Provider Business Mailing Address
First Line	:	21 GARFIELD PL
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45202-4301
Country	:	US
Telephone Number	:	513-721-0277
Fax Number	:	513-721-2824

Provider Business Practice Location Address
First Line	:	21 GARFIELD PL
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45202-4301
Country	:	US
Telephone Number	:	513-721-0277
Fax Number	:	513-721-2824

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. PAMELA KOHRMAN
Credential	:	RPH
Telephone Number	:	513-721-0277

Provider Enumeration Date	:	03/22/2006
Last Update Date	:	11/12/2009

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