Active NPI
Benjamin Kenneth Reagh, PHARM D
- Pharmacist
- Flagler Beach, FL
National Provider Identifier
1033713425
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS46322
- Practice address
- 2301 Moody Blvd
Flagler Beach, FL 32136-4427 - Phone
- (386) 439-0271
- NPI assigned
- Nov 25, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS46322 | FL | Primary |
Addresses
Primary practice location
2301 Moody Blvd
Flagler Beach, FL 32136-4427
Mailing address
332 Tuscany Chase Dr
Daytona Beach, FL 32117-5520
Phone (386) 290-3085
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS46322 | FL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606262400000",
"number": "1033713425",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "332 TUSCANY CHASE DR",
"city": "DAYTONA BEACH",
"state": "FL",
"postal_code": "321175520",
"telephone_number": "386-290-3085"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2301 MOODY BLVD",
"city": "FLAGLER BEACH",
"state": "FL",
"postal_code": "321364427",
"telephone_number": "386-439-0271"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REAGH",
"first_name": "BENJAMIN",
"middle_name": "KENNETH",
"name_prefix": "Dr.",
"credential": "PHARM D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-11-25",
"last_updated": "2020-11-25",
"certification_date": "2020-11-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS46322",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Flagler Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.