Provider Demographics
NPI:1013073519
Name:WHITTINGTON, BENNY KEVIN (RPH)
Entity Type:Individual
Prefix:MR
First Name:BENNY
Middle Name:KEVIN
Last Name:WHITTINGTON
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 1:4979 KEOHONE DR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32309-2750
Mailing Address - Country:US
Mailing Address - Phone:850-294-6425
Mailing Address - Fax:
Practice Address - Street 1:4979 KEOHONE DR
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32309-2750
Practice Address - Country:US
Practice Address - Phone:850-294-6425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS26104183500000X, 1835P1200X
FLPU50331835G0303X, 1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered183500000XPharmacy Service ProvidersPharmacist
Not Answered1835G0303XPharmacy Service ProvidersPharmacistGeriatric
Not Answered1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy