Provider Demographics
NPI:1174044663
Name:PAROLINI, BENJAMIN CARL (PHARM D)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:CARL
Last Name:PAROLINI
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:397 5TH ST
Mailing Address - Street 2:
Mailing Address - City:GUSTINE
Mailing Address - State:CA
Mailing Address - Zip Code:95322-1236
Mailing Address - Country:US
Mailing Address - Phone:209-854-1007
Mailing Address - Fax:209-854-6768
Practice Address - Street 1:397 5TH ST
Practice Address - Street 2:
Practice Address - City:GUSTINE
Practice Address - State:CA
Practice Address - Zip Code:95322-1236
Practice Address - Country:US
Practice Address - Phone:209-854-1007
Practice Address - Fax:209-854-6768
Is Sole Proprietor?:No
Enumeration Date:2017-07-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45004183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist