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NPI Code Detail

MEDICARE: BENZER MS 1 LLC

MEDICARE: BENZER MS 1 LLC
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
1333600000XPharmacy
23336C0003XCommunity/Retail Pharmacy142461/1.1MS
33336C0003XCommunity/Retail Pharmacy

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1404473OTHERMSMEDICARE PART B

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
22150623OTHERPK
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1235522756
Entity Type Code : Organization
Provider Name (Legal Business Name) : BENZER MS 1 LLC
Provider Business Mailing Address
First Line : 5908 BRECKENRIDGE PARKWAY
Second Line :
City : TAMPA
State : FL
Zip : 33610
Country : US
Telephone Number : 813-304-2221
Fax Number : 888-239-8423
Provider Business Practice Location Address
First Line : 1720A MEDICAL PARK DR STE 160
Second Line :
City : BILOXI
State : MS
Zip : 39532-2135
Country : US
Telephone Number : 228-207-7716
Fax Number : 228-207-9598
Authorized Official
Title or Position : OWNER
Name : ALPESH PATEL
Credential :
Telephone Number : 813-304-2221
Provider Enumeration Date : 03/09/2015
Last Update Date : 07/26/2018

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Directions to “BENZER MS 1 LLC ” Practice Location

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