Provider Demographics
NPI:1245585561
Name:RITCHIE, BENJAMIN DAVID
Entity Type:Individual
Prefix:MR
First Name:BENJAMIN
Middle Name:DAVID
Last Name:RITCHIE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1156 SILVER BIRCH DR
Mailing Address - Street 2:
Mailing Address - City:MENASHA
Mailing Address - State:WI
Mailing Address - Zip Code:54952-3519
Mailing Address - Country:US
Mailing Address - Phone:920-540-6544
Mailing Address - Fax:
Practice Address - Street 1:1156 SILVER BIRCH DR
Practice Address - Street 2:
Practice Address - City:MENASHA
Practice Address - State:WI
Practice Address - Zip Code:54952-3519
Practice Address - Country:US
Practice Address - Phone:920-540-6544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-24
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies