Individual
DR. BENJAMIN ROLAND BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1704 MEADOWS LN, VIDALIA, GA 30474-8913
(912) 537-4147
(912) 537-1914
Mailing address
3526 MOUNT VERNON ALSTON RD, MOUNT VERNON, GA 30445-2301
(912) 594-6061
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH022024
GA
Other
Enumeration date
06/13/2006
Last updated
03/31/2023
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