Benjamin Bradley Lacross, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

5302413716 Issued in MI

Practice address

4900 M 72 E
Williamsburg, MI 49690-9455

Phone

(231) 534-9810

NPI assigned

Aug 18, 2021

Sex

Male

Sole proprietor

No

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Rite Aid of Michigan Inc

  • Community/Retail Pharmacy
  • Traverse City, MI
  • NPI 1508876053
  NPD (past)
• Rite Aid of Michigan Inc

  • Community/Retail Pharmacy
  • Washington, MI
  • NPI 1619117405
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 5, 2023.

{
    "created_epoch": "1629244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688515200000",
    "number": "1972279099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 KINGSTON CT APT C3",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496841481",
            "telephone_number": "906-440-9569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 M 72 E",
            "city": "WILLIAMSBURG",
            "state": "MI",
            "postal_code": "496909455",
            "telephone_number": "231-534-9810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACROSS",
        "first_name": "BENJAMIN",
        "middle_name": "BRADLEY",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-18",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302413716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul Alan Jensen, R.PH.
• Angela McAlpine Keas, D.C.
• Lindsay Kate King, LMSW
• Kenneth Allen Kleyn, MD
• Kara S Koeplin, OTR
• Abigail Larsen
• Christina Jean Lukas, MT, LLPC
• Trevor Michael Massey, PHARM.D
• David Blake May, D.O.
• Zachary J McGiness, PHARMD

• All providers in Williamsburg, MI
• Pharmacist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2023; 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.