Organization
BENZER FL 5 LLC
Active
Other names
Benzer Pharmacy 144
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA JOHNSTON (PRESIDENT, AO)
(386) 672-0600
Entity
Organization
Contact information
Practice address
500 W GRANADA BLVD STE 4, ORMOND BEACH, FL 32174-2304
(386) 672-0600
(386) 672-0700
Mailing address
500 W GRANADA BLVD STE 4, ORMOND BEACH, FL 32174-2304
(386) 672-0600
(888) 239-8423
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH29731
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016511500
—
FL
01
—
2156207
PK
—
Enumeration date
12/08/2010
Last updated
02/20/2019
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