Provider Demographics
NPI:1538477468
Name:BENDER, BETTINA LEIGH (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BETTINA
Middle Name:LEIGH
Last Name:BENDER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4421 AIRLINE DR
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001-5660
Mailing Address - Country:US
Mailing Address - Phone:504-836-2316
Mailing Address - Fax:
Practice Address - Street 1:4421 AIRLINE DR
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-5660
Practice Address - Country:US
Practice Address - Phone:504-836-2316
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-14
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA18591183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist