Individual
EDDIE R BENJAMIN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
1791 ALUM CREEK DR, COLUMBUS, OH 43207
(614) 445-8131
Mailing address
1152 TULSA DR, COLUMBUS, OH 43229-5513
(619) 997-8952
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
162941
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0129422
—
OH
Enumeration date
05/22/2017
Last updated
05/15/2018
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