Individual
MR. JAMES ALBERT BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH, CDE
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
E5169
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E5169
LICENSE
MS
Enumeration date
05/01/2007
Last updated
03/26/2013
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