MEDICARE: PATRICIA BENTZ PHARM.D

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	183500000X	Pharmacist	011517	KY

General Provider Information

NPI Number	:	1699372821
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA BENTZ PHARM.D

Provider Business Mailing Address
First Line	:	12803 DOVE LAKE DR
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40299-8341
Country	:	US
Telephone Number	:	502-542-1611
Fax Number	:

Provider Business Practice Location Address
First Line	:	12803 DOVE LAKE DR
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40299-8341
Country	:	US
Telephone Number	:	502-542-1611
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/01/2020
Last Update Date	:	10/01/2020

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Directions to “ PATRICIA BENTZ PHARM.D” Practice Location

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