Provider Demographics
NPI:1023489283
Name:KIRBY, BENJAMIN PALMER (PHARM D)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:PALMER
Last Name:KIRBY
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 S STADIUM RD
Mailing Address - Street 2:APT S711
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-5404
Mailing Address - Country:US
Mailing Address - Phone:803-270-2542
Mailing Address - Fax:
Practice Address - Street 1:1795 WHISKEY RD
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29803-7337
Practice Address - Country:US
Practice Address - Phone:803-642-5371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-14
Last Update Date:2015-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC36108183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist