Provider Demographics
NPI:1568831642
Name:HONEST OAK LLC
Entity Type:Organization
Organization Name:HONEST OAK LLC
Other - Org Name:BEN'S FAMILY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FERREE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD OF PHARMACY
Authorized Official - Phone:309-750-1827
Mailing Address - Street 1:PO BOX 130
Mailing Address - Street 2:
Mailing Address - City:LIMON
Mailing Address - State:CO
Mailing Address - Zip Code:80828-0130
Mailing Address - Country:US
Mailing Address - Phone:309-750-1827
Mailing Address - Fax:719-775-0555
Practice Address - Street 1:333 M AVE
Practice Address - Street 2:#100
Practice Address - City:LIMON
Practice Address - State:CO
Practice Address - Zip Code:80828
Practice Address - Country:US
Practice Address - Phone:309-750-1827
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-18
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO63770059Medicaid