Provider Demographics
NPI:1033477690
Name:CHEN, BEN YI
Entity Type:Individual
Prefix:MR
First Name:BEN
Middle Name:YI
Last Name:CHEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 COBB PKWY
Mailing Address - Street 2:
Mailing Address - City:RINGGOLD
Mailing Address - State:GA
Mailing Address - Zip Code:30736-8566
Mailing Address - Country:US
Mailing Address - Phone:706-891-2586
Mailing Address - Fax:706-891-2583
Practice Address - Street 1:100 COBB PKWY
Practice Address - Street 2:
Practice Address - City:RINGGOLD
Practice Address - State:GA
Practice Address - Zip Code:30736-8566
Practice Address - Country:US
Practice Address - Phone:706-891-2586
Practice Address - Fax:706-891-2583
Is Sole Proprietor?:No
Enumeration Date:2012-05-01
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH022034183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist