Keith Dylan Bennett, PHARM.D.
Individual provider Active NPI Pharmacist · Coventry, RI
NPI 1871909705 · NPPES record last updated Jul 11, 2014
Key facts
- NPI
- 1871909705
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- RPH05324 (RI)
- Practice address
- 875 Tiogue Ave
Coventry, RI 02816-6300 - Phone
- (401) 822-7602
- NPI assigned
- Jul 11, 2014
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH05324 | RI | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH05324 | RI | Yes |
Addresses
Primary practice location
875 Tiogue Ave
Coventry, RI 02816-6300
Mailing address
875 Tiogue Ave
Coventry, RI 02816-6300
Other providers in Coventry, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 11, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.