1922045871 NPI number — KAREN HENARD BENHAMRON, D.C.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922045871 NPI number — KAREN HENARD BENHAMRON, D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KAREN HENARD BENHAMRON, D.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1922045871
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/27/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4566 E HIGHWAY 20
Provider Second Line Business Mailing Address:
SUITE 205
Provider Business Mailing Address City Name:
NICEVILLE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32578-8838
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
850-897-1105
Provider Business Mailing Address Fax Number:
850-897-1108

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4566 E HIGHWAY 20
Provider Second Line Business Practice Location Address:
SUITE205
Provider Business Practice Location Address City Name:
NICEVILLE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32578-8838
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
850-897-1105
Provider Business Practice Location Address Fax Number:
850-897-1108
Provider Enumeration Date:
06/01/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BENHAMRON
Authorized Official First Name:
KAREN
Authorized Official Middle Name:
HENARD
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
850-897-1105

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  CH7913 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1326040452 . This is a "NPI ATTATCHED TO MY SS#" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 381265100 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1225282155 . This is a "NPI ATTACHED TO HENARD FAMILY CHIROPRACTIC, INC." identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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