Provider Demographics
NPI:1215568951
Name:BENSON, MARIA CHRISTINA (RPH)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:CHRISTINA
Last Name:BENSON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1657 25TH ST NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44709-3421
Mailing Address - Country:US
Mailing Address - Phone:330-456-2476
Mailing Address - Fax:330-456-1973
Practice Address - Street 1:1657 25TH ST NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44709-3421
Practice Address - Country:US
Practice Address - Phone:330-456-2476
Practice Address - Fax:330-456-1973
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-31
Last Update Date:2020-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03219488183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist