Active NPI
Benjamin Love
- Pharmacist
- Gouverneur, NY
National Provider Identifier
1508239476
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- I055508
- Practice address
- 471 E Main St Ste 5
Gouverneur, NY 13642-1508 - Phone
- (855) 358-1294
- Fax
- (315) 287-9250
- NPI assigned
- Nov 2, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | I055508 | NY | Primary |
Addresses
Primary practice location
471 E Main St Ste 5
Gouverneur, NY 13642-1508
Mailing address
471 E Main St
Suite 2
Gouverneur, NY 13642-1508
Phone (855) 358-1294
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
| License | State | Type | Specialty |
|---|---|---|---|
| I055508 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1446422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1567555200000",
"number": "1508239476",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "471 E MAIN ST",
"address_2": "SUITE 2",
"city": "GOUVERNEUR",
"state": "NY",
"postal_code": "136421508",
"telephone_number": "855-358-1294",
"fax_number": "315-287-9250"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "471 E MAIN ST STE 5",
"city": "GOUVERNEUR",
"state": "NY",
"postal_code": "136421508",
"telephone_number": "855-358-1294",
"fax_number": "315-287-9250"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOVE",
"first_name": "BENJAMIN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-11-02",
"last_updated": "2019-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "I055508",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gouverneur, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.