NPIMap

Organization Active NPI

Benton Discount Pharmacy (Epsdt)

  • Specialty Pharmacy
  • Benton, KY
National Provider Identifier
1346427242
Registry record updated Oct 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Specialty PharmacyTaxonomy code 3336S0011X
License
P01049 Issued in KY
Legal business name
BENTON DISCOUNT PHARMACY (EPSDT)
Practice address
2606 Main St
Benton, KY 42025-1819
Phone
(270) 527-1409
Fax
(270) 527-2801
NPI assigned
Jan 23, 2008
Last updated
Oct 6, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
BENTON DISCOUNT PHARMACYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 6, 2021

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

Authorized official

Name
Morgan Beck, RPH
Title
Pharmacist/Pharmacy MGR
Phone
(270) 527-1409

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialty Pharmacy 3336S0011X P01049 KY Primary

Addresses

Primary practice location

2606 Main St
Benton, KY 42025-1819

Mailing address

2606 Main St
Benton, KY 42025-1819
Phone (270) 527-1409

Other identifiers 1

IdentifierTypeStateIssuer
54013990MedicaidKY

National Provider Directory

National Provider Directory
Tax ID family
Draffenville Pharmacy3 organizations share this tax ID, including this one
Part of
Draffenville Pharmacy

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2602 Main St
Benton, KY 42025
Phone (270) 527-1409

NPI Registry JSON

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

{
    "created_epoch": "1201046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633478400000",
    "number": "1346427242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2606 MAIN ST",
            "city": "BENTON",
            "state": "KY",
            "postal_code": "420251819",
            "telephone_number": "270-527-1409",
            "fax_number": "270-527-2801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2606 MAIN ST",
            "city": "BENTON",
            "state": "KY",
            "postal_code": "420251819",
            "telephone_number": "270-527-1409",
            "fax_number": "270-527-2801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENTON DISCOUNT PHARMACY (EPSDT)",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BENTON DISCOUNT PHARMACY",
        "enumeration_date": "2008-01-23",
        "last_updated": "2021-10-06",
        "certification_date": "2021-10-06",
        "status": "A",
        "authorized_official_last_name": "BECK",
        "authorized_official_first_name": "MORGAN",
        "authorized_official_title_or_position": "PHARMACIST/PHARMACY MGR",
        "authorized_official_telephone_number": "270-527-1409",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "KY",
            "license": "P01049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "54013990",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Benton, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2021; 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.