Provider Demographics
NPI:1821641721
Name:VEKSLER, BENJAMIN SAMUEL (PHARMD)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:SAMUEL
Last Name:VEKSLER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1359 POPLAR AVE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-2044
Mailing Address - Country:US
Mailing Address - Phone:901-276-5491
Mailing Address - Fax:
Practice Address - Street 1:1359 POPLAR AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-2044
Practice Address - Country:US
Practice Address - Phone:901-276-5491
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-19
Last Update Date:2019-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN411453336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy