Active NPI
Benjamin Bredhold, PHARMD
- Pharmacist
- Morgantown, WV
National Provider Identifier
1952883001
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP0010559
- Practice address
- 1 Medical Center Drive
Dept of Pharmaceutical Services
Morgantown, WV 26505 - Phone
- (304) 598-4148
- Fax
- (304) 598-4073
- NPI assigned
- Sep 5, 2018
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 40577 | TN | |
| Pharmacist | 183500000X | 26026568A | IN | |
| Pharmacist | 183500000X | RP0010559 | WV | Primary |
Addresses
Primary practice location
1 Medical Center Drive
Dept of Pharmaceutical Services
Morgantown, WV 26505
Mailing address
1 Medical Center Drive
Dept of Pharmaceutical Services (Box 8045)
Morgantown, WV 26505
Phone (304) 598-4148
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26026568A | IN | MD | Pharmacist |
| RP0010559 | WV | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1536105600000",
"number": "1952883001",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 MEDICAL CENTER DRIVE",
"address_2": "DEPT OF PHARMACEUTICAL SERVICES (BOX 8045)",
"city": "MORGANTOWN",
"state": "WV",
"postal_code": "26505",
"telephone_number": "304-598-4148",
"fax_number": "304-598-4073"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 MEDICAL CENTER DRIVE",
"address_2": "DEPT OF PHARMACEUTICAL SERVICES",
"city": "MORGANTOWN",
"state": "WV",
"postal_code": "26505",
"telephone_number": "304-598-4148",
"fax_number": "304-598-4073"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BREDHOLD",
"first_name": "BENJAMIN",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-09-05",
"last_updated": "2018-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TN",
"license": "40577",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IN",
"license": "26026568A",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WV",
"license": "RP0010559",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Morgantown, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.