Provider Demographics
NPI:1376082123
Name:BENSONS PHARMACY II
Entity Type:Organization
Organization Name:BENSONS PHARMACY II
Other - Org Name:FARMACIA HISPANA
Other - Org Type:Other Name
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:COBBINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BENSON ADJEI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-281-5762
Mailing Address - Street 1:3530 HICKORY HILL RD
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38115-3840
Mailing Address - Country:US
Mailing Address - Phone:901-281-5762
Mailing Address - Fax:901-552-5953
Practice Address - Street 1:6005 PARK AVE STE 121B
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-5202
Practice Address - Country:US
Practice Address - Phone:901-315-9676
Practice Address - Fax:901-552-5953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-13
Last Update Date:2020-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336L0003X
TN0059533336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2167991OtherPK