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NPI Code Detail

MEDICARE: SCOTT M BENSON II RPH

MEDICARE: SCOTT M BENSON II RPH
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
1183500000XPharmacist114634-5MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1114634-5OTHERMNPHARMACIST LICENCE

General Provider Information

NPI Number : 1396720553
Entity Type Code : Individual
Provider Name (Legal Business Name) : SCOTT M BENSON II RPH
Provider Business Mailing Address
First Line : 15245 BLUEBIRD ST NW
Second Line :
City : ANDOVER
State : MN
Zip : 55304-3538
Country : US
Telephone Number : 763-434-1901
Fax Number :
Provider Business Practice Location Address
First Line : 15245 BLUEBIRD ST NW
Second Line :
City : ANDOVER
State : MN
Zip : 55304-3538
Country : US
Telephone Number : 763-434-1901
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/09/2005
Last Update Date : 07/08/2007

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Directions to “ SCOTT M BENSON II RPH” Practice Location

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