Provider Demographics
NPI:1154494235
Name:GROSS, BENJAMIN NEIL (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:NEIL
Last Name:GROSS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 UNIVERSITY PARK DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37204-3956
Mailing Address - Country:US
Mailing Address - Phone:270-366-3976
Mailing Address - Fax:
Practice Address - Street 1:1 UNIVERSITY PARK DR
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37204-3956
Practice Address - Country:US
Practice Address - Phone:615-966-7195
Practice Address - Fax:615-966-7163
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2013-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN26996183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist