Active NPI
Fred Bencivengo, R.PH
- Pharmacist
- Warren, OH
National Provider Identifier
1548927031
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 03219433
- Practice address
- 3556 Layer Rd SW
Warren, OH 44481-9191 - Phone
- (330) 898-2042
- NPI assigned
- Nov 19, 2021
- Sex
- Male
- Sole proprietor
- No
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 | 03219433 | OH | Primary |
Addresses
Primary practice location
3556 Layer Rd SW
Warren, OH 44481-9191
Mailing address
909 E Main St
Ravenna, OH 44266-3325
Phone (330) 296-7115
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | fred.bencivengo@gianteagle.com | Health Information Exchange (HIE) |
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
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03219433 | OH | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Tamarkin Company | Past | Accepting new patients | |
| The Tamarkin Company | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Giant Eagle Pharmacy 6348
- Community/Retail Pharmacy
- Ravenna, OH
- NPI 1326053240
-
dba Giant Eagle Pharmacy #4093
- Community/Retail Pharmacy
- Erie, PA
- NPI 1427063353
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1637280000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637280000000",
"number": "1548927031",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "909 E MAIN ST",
"city": "RAVENNA",
"state": "OH",
"postal_code": "442663325",
"telephone_number": "330-296-7115"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3556 LAYER RD SW",
"city": "WARREN",
"state": "OH",
"postal_code": "444819191",
"telephone_number": "330-898-2042"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENCIVENGO",
"first_name": "FRED",
"credential": "R.PH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-11-19",
"last_updated": "2021-11-19",
"certification_date": "2021-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OH",
"license": "03219433",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "fred.bencivengo@gianteagle.com",
"affiliation": "N",
"endpointDescription": "email",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "3556 Layer Rd SW",
"city": "Warren",
"state": "OH",
"country_code": "US",
"postal_code": "444819191",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Warren, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.