Provider Demographics
NPI:1164007530
Name:VOGEL, BENJAMIN JOHN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:JOHN
Last Name:VOGEL
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 1:10222 N 185TH CIR
Mailing Address - Street 2:
Mailing Address - City:BENNINGTON
Mailing Address - State:NE
Mailing Address - Zip Code:68007-1580
Mailing Address - Country:US
Mailing Address - Phone:402-312-5154
Mailing Address - Fax:
Practice Address - Street 1:6528 S 118TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68137-3577
Practice Address - Country:US
Practice Address - Phone:402-592-4600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-16
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE14302183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist