Provider Demographics
NPI:1194741793
Name:BENGE, CASSANDRA D (RPH,PHARMD,BCPS AQCV)
Entity type:Individual
Prefix:MRS
First Name:CASSANDRA
Middle Name:D
Last Name:BENGE
Suffix:
Gender:F
Credentials:RPH,PHARMD,BCPS AQCV
Other - Prefix:MISS
Other - First Name:CASSANDRA
Other - Middle Name:ELIZABETH
Other - Last Name:DAPPER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH,PHARMD,BCPS AQCV
Mailing Address - Street 1:1310 24TH AVE S
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37212-2637
Mailing Address - Country:US
Mailing Address - Phone:615-327-4751
Mailing Address - Fax:
Practice Address - Street 1:1310 24TH AVE S
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37212-2637
Practice Address - Country:US
Practice Address - Phone:615-327-4751
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2018-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX41463183500000X
AL137061835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
No183500000XPharmacy Service ProvidersPharmacist