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Organization
BENZER MS 1 LLC
Active
Organization
BENZER MS 1 LLC
Active
Other names
Benzer Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ALPESH PATEL (OWNER)
(813) 304-2221
Entity
Organization
Contact information
Practice address
1720A MEDICAL PARK DR STE 160, BILOXI, MS 39532-2135
(228) 207-7716
(228) 207-9598
Mailing address
5908 BRECKENRIDGE PARKWAY, TAMPA, FL 33610
(813) 304-2221
(888) 239-8423
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
142461/1.1
MS
3336C0003X
Community/Retail Pharmacy
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06972060
—
MS
01
—
2150623
PK
—
01
—
404473
MEDICARE PART B
MS
Enumeration date
03/09/2015
Last updated
07/26/2018
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