Organization Active NPI

Benton Discount Pharmacy Inc

Doing business as Draffenville Pharmacy

  • Community/Retail Pharmacy
  • Benton, KY
National Provider Identifier
1659389864
Registry record updated Dec 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
P02124 Issued in KY
Legal business name
BENTON DISCOUNT PHARMACY INC
Doing business as
Draffenville Pharmacy
Practice address
153 US Highway 68 E
Benton, KY 42025-7123
Phone
(270) 527-1404
NPI assigned
Aug 3, 2006
Last updated
Dec 19, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2023

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

Authorized official

Name
Morgan Beck, RPH
Title
Pharmacist
Phone
(270) 527-1404

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X P02124 KY
Community/Retail Pharmacy 3336C0003X P02124 KY Primary

Addresses

Primary practice location

153 US Highway 68 E
Benton, KY 42025-7123

Mailing address

153 US Highway 68 E
Benton, KY 42025-7123
Phone (270) 527-1404

Other identifiers 2

IdentifierTypeStateIssuer
54023569MedicaidKY
K165180OtherKYMASS IMMUNIZATION

Other names 1

  • DRAFFENVILLE PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20210423000415 KY Part B Supplier - Independent Clinical Laboratory 5597882894 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Benton, KY
O20240214001399 KY Part B Supplier - Pharmacy 5597882894 Practice locations: Benton, KY

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702944000000",
    "number": "1659389864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 US HIGHWAY 68 E",
            "city": "BENTON",
            "state": "KY",
            "postal_code": "420257123",
            "telephone_number": "270-527-1404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 US HIGHWAY 68 E",
            "city": "BENTON",
            "state": "KY",
            "postal_code": "420257123",
            "telephone_number": "270-527-1404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENTON DISCOUNT PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-03",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A",
        "authorized_official_last_name": "BECK",
        "authorized_official_first_name": "MORGAN",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "270-527-1404",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KY",
            "license": "P02124",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "KY",
            "license": "P02124",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "54023569",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASS IMMUNIZATION",
            "identifier": "K165180",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DRAFFENVILLE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "DRAFFENVILLE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Dec 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.