Provider Demographics
NPI:1538294210
Name:BENINATE, PAULETTE (RPH)
Entity Type:Individual
Prefix:MS
First Name:PAULETTE
Middle Name:
Last Name:BENINATE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1581 CAROL SUE AVE
Mailing Address - Street 2:SUITE E
Mailing Address - City:GRETNA
Mailing Address - State:LA
Mailing Address - Zip Code:70056-5100
Mailing Address - Country:US
Mailing Address - Phone:504-394-9037
Mailing Address - Fax:504-392-0973
Practice Address - Street 1:1581 CAROL SUE AVE
Practice Address - Street 2:SUITE E
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70056-5100
Practice Address - Country:US
Practice Address - Phone:504-394-9037
Practice Address - Fax:504-392-0973
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA10747183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist