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Individual

DR. KADIAN BENNETT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHARMD

Contact information

Practice address
4030 ANNAS RETREAT, CHARLOTTE AMALIE, VI 00802-2221
(340) 777-9255
Mailing address
4030 ANNAS RETREAT, CHARLOTTE AMALIE, VI 00802-2221
(340) 777-9255

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
359
VI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
359
VIRGIN ISLANDS PHARMACIST LICENSE
VI
01
50-3800
APHA
01
PS52183
APHA
FL
Enumeration date
09/27/2019
Last updated
10/02/2019
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