Provider Demographics
NPI:1184238248
Name:HARBIN, BENJAMIN TYLER (PHARMD)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:TYLER
Last Name:HARBIN
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 1:528 W TENNESSEE AVE
Mailing Address - Street 2:
Mailing Address - City:PINEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40977-1437
Mailing Address - Country:US
Mailing Address - Phone:606-337-1444
Mailing Address - Fax:606-337-1499
Practice Address - Street 1:528 W TENNESSEE AVE
Practice Address - Street 2:
Practice Address - City:PINEVILLE
Practice Address - State:KY
Practice Address - Zip Code:40977-1437
Practice Address - Country:US
Practice Address - Phone:606-337-1444
Practice Address - Fax:606-337-1499
Is Sole Proprietor?:No
Enumeration Date:2020-09-04
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY019440183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist