Provider Demographics
NPI:1003995770
Name:BENSON PHARMACY INC
Entity Type:Organization
Organization Name:BENSON PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BENITO
Authorized Official - Middle Name:
Authorized Official - Last Name:BELEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-548-7777
Mailing Address - Street 1:11380 66TH ST
Mailing Address - Street 2:SUITE 138
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33773-5531
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11380 66TH ST
Practice Address - Street 2:SUITE 138
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33773-5531
Practice Address - Country:US
Practice Address - Phone:727-548-7777
Practice Address - Fax:727-545-1111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336C0003X
FLPH221673336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1023035OtherOTHER ID NUMBER-COMMERCIAL NUMBER
1023035OtherOTHER ID NUMBER