Provider Demographics
NPI:1164812848
Name:KNOWLES, BENJAMIN (RPH,PHARMD)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:
Last Name:KNOWLES
Suffix:
Gender:M
Credentials:RPH,PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1945 VETERANS BLVD
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:GA
Mailing Address - Zip Code:31021-3001
Mailing Address - Country:US
Mailing Address - Phone:478-272-8851
Mailing Address - Fax:478-274-8878
Practice Address - Street 1:1945 VETERANS BLVD
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:GA
Practice Address - Zip Code:31021-3001
Practice Address - Country:US
Practice Address - Phone:478-272-8851
Practice Address - Fax:478-274-8878
Is Sole Proprietor?:No
Enumeration Date:2015-02-02
Last Update Date:2019-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH023739183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist