Provider Demographics
NPI:1376989608
Name:RICHTER, BENJAMIN EDWIN (CPHT)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:EDWIN
Last Name:RICHTER
Suffix:
Gender:M
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2431 N GERMANTOWN PKWY
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38016-4422
Mailing Address - Country:US
Mailing Address - Phone:901-214-0002
Mailing Address - Fax:901-214-0010
Practice Address - Street 1:2431 N GERMANTOWN PKWY
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38016-4422
Practice Address - Country:US
Practice Address - Phone:901-214-0002
Practice Address - Fax:901-214-0010
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-14
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN38776183700000X
TN0000046473183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No183700000XPharmacy Service ProvidersPharmacy Technician