Jesse Thomas Bender

Key facts

NPI

1356870596

Entity type

Individual (NPI type 1)

Primary specialty

Pharmacist 183500000X

License

RP448122 (PA)

Practice address

1102 Montour Rd
Loysville, PA 17047-9200

Phone

(717) 789-3093

Fax

(717) 789-9451

NPI assigned

Jun 10, 2017

Sex

Male

Sole proprietor

No

Organizations & group practices 1

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.

• West Perry Pharmacy Inc Community/Retail Pharmacy · Loysville, PA · NPI 1508872300
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Practice roles

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 10, 2017.

{
    "created_epoch": "1497052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497052800000",
    "number": "1356870596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 MONTOUR RD",
            "city": "LOYSVILLE",
            "state": "PA",
            "postal_code": "170479200",
            "telephone_number": "717-789-3093",
            "fax_number": "717-789-9451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 MONTOUR RD",
            "city": "LOYSVILLE",
            "state": "PA",
            "postal_code": "170479200",
            "telephone_number": "717-789-3093",
            "fax_number": "717-789-9451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENDER",
        "first_name": "JESSE",
        "middle_name": "THOMAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-10",
        "last_updated": "2017-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP448122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Loysville, PA · Pharmacist in Pennsylvania