Benneth Chukwudi Ejesi, RPH – Pharmacist

Key facts

NPI: 1295018141
Entity type: Individual (NPI type 1)
Primary specialty: Pharmacist 183500000X
License: PH21369 (MA)
Practice address: 501 Sumner Ave
Springfield, MA 01108-2306
Phone: (413) 746-1563
Fax: (413) 747-9833
NPI assigned: Sep 27, 2011
Sex: Male
Sole proprietor: No

Organizations & group practices 2

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.

Walgreen Co Pharmacy · Springfield, MA · NPI 1801801014

NPD (past)
Walgreen Co Pharmacy · Longview, TX · NPI 1629956545

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No
Credentials: Registered Pharmacist

State licenses

License	State	Type	Specialty
PCT.0008913	CT	MD	Pharmacist
PH21369	MA	MD	Pharmacist

Practice roles

Organization	Specialty	Status	New patients
Walgreen Co		Past	Accepting new patients
Walgreen Co		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Pharmacist	183500000X	PH21369	MA	Yes
Pharmacist	183500000X	PCT.0008913	CT

Addresses

Primary practice location

501 Sumner Ave
Springfield, MA 01108-2306

Mailing address

50 Day St
Feeding Hills, MA 01030-2304
Phone (413) 746-1563

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 27, 2011.

{
    "created_epoch": "1317081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317081600000",
    "number": "1295018141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 DAY ST",
            "city": "FEEDING HILLS",
            "state": "MA",
            "postal_code": "010302304",
            "telephone_number": "413-746-1563",
            "fax_number": "413-747-9833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 SUMNER AVE",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011082306",
            "telephone_number": "413-746-1563",
            "fax_number": "413-747-9833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EJESI",
        "first_name": "BENNETH",
        "middle_name": "CHUKWUDI",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-27",
        "last_updated": "2011-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "PH21369",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CT",
            "license": "PCT.0008913",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

All providers in Springfield, MA · Pharmacist in Massachusetts

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 27, 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.

Verify at the official NPI Registry.