Provider Demographics
NPI:1194038497
Name:BENTZ, JOHN CHRISTOPHER (RPH)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:CHRISTOPHER
Last Name:BENTZ
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4400 GOLF ACRES DR
Mailing Address - Street 2:BLDG J, SUITE B1
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28208
Mailing Address - Country:US
Mailing Address - Phone:704-512-6057
Mailing Address - Fax:704-512-6058
Practice Address - Street 1:4400 GOLF ACRES DR
Practice Address - Street 2:BLDG J, SUITE E
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28208-5990
Practice Address - Country:US
Practice Address - Phone:704-512-7902
Practice Address - Fax:704-512-7630
Is Sole Proprietor?:No
Enumeration Date:2010-07-15
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRPH03932183500000X
NC13861183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist