Provider Demographics
NPI:1821444076
Name:BENTEMAN, BARRY (RPH)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:
Last Name:BENTEMAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2249 SE STINSON DR
Mailing Address - Street 2:
Mailing Address - City:TECUMSEH
Mailing Address - State:KS
Mailing Address - Zip Code:66542-9418
Mailing Address - Country:US
Mailing Address - Phone:785-640-5597
Mailing Address - Fax:
Practice Address - Street 1:2010 SE 29TH ST
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66605-2596
Practice Address - Country:US
Practice Address - Phone:785-267-0234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-06
Last Update Date:2016-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS09231183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist