Provider Demographics
NPI:1750423810
Name:BENNETT PHARMACY INC
Entity type:Organization
Organization Name:BENNETT PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:DENINGER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:319-337-3526
Mailing Address - Street 1:250 S LINN AVE
Mailing Address - Street 2:
Mailing Address - City:NEW HAMPTON
Mailing Address - State:IA
Mailing Address - Zip Code:50659-2020
Mailing Address - Country:US
Mailing Address - Phone:641-394-4156
Mailing Address - Fax:641-394-4155
Practice Address - Street 1:1 W MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW HAMPTON
Practice Address - State:IA
Practice Address - Zip Code:50659-2101
Practice Address - Country:US
Practice Address - Phone:641-394-4156
Practice Address - Fax:641-394-4155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA13531183500000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1600104OtherNAPB NUMBER
IA0011148Medicaid
IA1600104OtherNAPB NUMBER