Individual provider Active NPI

Benjamin Jon Holland

  • Pharmacist
  • West Fargo, ND
National Provider Identifier
1366334518
Registry record updated Aug 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH6458 Issued in ND
Practice address
1210 Sheyenne St
West Fargo, ND 58078-2637
Phone
(701) 282-4665
NPI assigned
Jul 21, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X RPH6458 ND Primary

Addresses

Primary practice location

1210 Sheyenne St
West Fargo, ND 58078-2637

Mailing address

1210 Sheyenne St
West Fargo, ND 58078-2637

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RPH6458NDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
The Prescription Shop Inc PastSince Jul 28, 2025 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1753056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754265600000",
    "number": "1366334518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 SHEYENNE ST",
            "city": "WEST FARGO",
            "state": "ND",
            "postal_code": "580782637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 SHEYENNE ST",
            "city": "WEST FARGO",
            "state": "ND",
            "postal_code": "580782637",
            "telephone_number": "701-282-4665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLAND",
        "first_name": "BENJAMIN",
        "middle_name": "JON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-07-21",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "ND",
            "license": "RPH6458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2025; 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.