Nicole Marie Benoit, PHARMD
Individual provider Active NPI Pharmacist · Agawam, MA
NPI 1114201779 · NPPES record last updated Sep 30, 2011
Key facts
- NPI
- 1114201779
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- PH233684 (MA)
- Practice address
- 60 Springfield St
Agawam, MA 01001-1522 - Phone
- (413) 786-1126
- NPI assigned
- Sep 30, 2011
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH233684 | MA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH233684 | MA | Yes |
Addresses
Primary practice location
60 Springfield St
Agawam, MA 01001-1522
Mailing address
60 Springfield St
Agawam, MA 01001-1522
Phone (413) 786-1126
Other providers in Agawam, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 30, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.