Provider Demographics
NPI:1851692164
Name:PHIPPS, BENJAMIN (PHARMD)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:
Last Name:PHIPPS
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 1:4000 W DIMOND BLVD
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99502-1475
Mailing Address - Country:US
Mailing Address - Phone:907-339-1260
Mailing Address - Fax:907-339-1219
Practice Address - Street 1:4000 W DIMOND BLVD
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99502-1475
Practice Address - Country:US
Practice Address - Phone:907-339-1260
Practice Address - Fax:907-339-1219
Is Sole Proprietor?:No
Enumeration Date:2010-11-03
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1864183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist