Benjamin Robert Oldham, PHARM.D.

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

26028034A Issued in IN

Practice address

4403 W Western Ave
South Bend, IN 46619-2640

Phone

(574) 234-3241

NPI assigned

Nov 29, 2020

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Hook-Superx LLC

  • Pharmacy
  • South Bend, IN
  • NPI 1578507935
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1606608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606608000000",
    "number": "1225632383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4237 IRISH HILLS DR APT 3A",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466146523",
            "telephone_number": "859-907-6037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4403 W WESTERN AVE",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466192640",
            "telephone_number": "574-234-3241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLDHAM",
        "first_name": "BENJAMIN",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-29",
        "last_updated": "2020-11-29",
        "certification_date": "2020-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "IN",
            "license": "26028034A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyle Offerle, RBT
• Modupe Mary Ogunnusi Sofuye, DMD
• Justus Ouma Ojwang, LCSW
• Olubunmi Abosede Okanlami, M.D.
• Alia Marie Olan
• Molly Elizabeth Oleary, BA
• Gerald Oler, OTR
• Terry Olson
• On-Site Health Solutions
• Jeffery Oney, PA-C

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in South Bend, IN
• Providers in South Bend, IN by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 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.

Verify at the official NPI Registry.