Individual provider Active NPI

Renee De Vaull-Benson

  • Pharmacist
  • Westland, MI
National Provider Identifier
1760013429
Registry record updated Jan 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302027433 Issued in MI
Practice address
31505 Joy Rd
Westland, MI 48185-1641
Phone
(734) 427-9102
NPI assigned
Jan 31, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302027433 MI Primary

Addresses

Primary practice location

31505 Joy Rd
Westland, MI 48185-1641

Mailing address

27378 Rosewood CT
Farmington Hills, MI 48334-4000
Phone (313) 802-2458

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
5302027433MIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1580428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580428800000",
    "number": "1760013429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27378 ROSEWOOD CT",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483344000",
            "telephone_number": "313-802-2458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31505 JOY RD",
            "city": "WESTLAND",
            "state": "MI",
            "postal_code": "481851641",
            "telephone_number": "734-427-9102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE VAULL-BENSON",
        "first_name": "RENEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-31",
        "last_updated": "2020-01-31",
        "certification_date": "2020-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302027433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2020; 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.