Provider Demographics
NPI:1063688927
Name:BENSON CHIROPRACTIC, PC
Entity Type:Organization
Organization Name:BENSON CHIROPRACTIC, PC
Other - Org Name:CHIROPRACTIC PROFESSIONALS OF COLUMBIA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DELEGATED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:NORBERT
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:BENSON II
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-667-8332
Mailing Address - Street 1:1301 ELMWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-2107
Mailing Address - Country:US
Mailing Address - Phone:803-888-6221
Mailing Address - Fax:803-888-6221
Practice Address - Street 1:1301 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-2107
Practice Address - Country:US
Practice Address - Phone:803-888-6221
Practice Address - Fax:803-888-6221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-01
Last Update Date:2018-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018049111N00000X
NY010294111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYC10294-9BOtherNEW YORK STATE WORKER'S COMPENSATION BOARD
NY113490ANOtherPREFERRED CARE
NYX8L55OtherEMPIRE PLAN
NY000980590001OtherPRISM
NY835773OtherMANAGED PHYSICAL NETWORK
NYP010010849OtherBLUE CHOICE
NY629920OtherUNITED HEALTHCARE
NYP010111294OtherBLUE CHOICE
NY175965ANOtherPREFERRED CARE
NY7538368OtherUNITED HEALTHCARE
NYC10849-OBOtherNEW YORK STATE WORKER'S COMPENSATION BOARD
NYP020111294OtherBC/BS
NY629920OtherAETNA
NY629921OtherAMERICAN CHIROPRACTIC NETWORK
NY7538368OtherAETNA
NYP020010849OtherBC/BS
NY113490ANOtherPREFERRED CARE
NY629921OtherAMERICAN CHIROPRACTIC NETWORK
NYAA1291Medicare PIN