Provider Demographics
NPI:1134349467
Name:BENSON, PAULETTE T (RPH)
Entity type:Individual
Prefix:MS
First Name:PAULETTE
Middle Name:T
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 1:144 PAR ST
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:UT
Mailing Address - Zip Code:84043-3971
Mailing Address - Country:US
Mailing Address - Phone:801-768-7055
Mailing Address - Fax:
Practice Address - Street 1:949 W GRASSLAND DR
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:UT
Practice Address - Zip Code:84003-2753
Practice Address - Country:US
Practice Address - Phone:801-492-1106
Practice Address - Fax:801-492-1108
Is Sole Proprietor?:No
Enumeration Date:2007-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT152945183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist