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NPI Code Detail

MEDICARE: MS. CATHERINE JANE BENHAM R.PH.

MEDICARE: MS. CATHERINE JANE BENHAM 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
1183500000XPharmacistPS23437FL
2183500000XPharmacist038013NY

General Provider Information

NPI Number : 1558431882
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CATHERINE JANE BENHAM R.PH.
Provider Business Mailing Address
First Line : PO BOX 618
Second Line :
City : MOUNT MARION
State : NY
Zip : 12456-0618
Country : US
Telephone Number : 845-483-3170
Fax Number : 845-483-9320
Provider Business Practice Location Address
First Line : 2834 ROUTE 17M
Second Line :
City : NEW HAMPTON
State : NY
Zip : 10958-5011
Country : US
Telephone Number : 845-374-8816
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/08/2006
Last Update Date : 01/10/2019

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