Provider Demographics
NPI:1861722886
Name:JONES, BENNY RAY (RPH)
Entity type:Individual
Prefix:MR
First Name:BENNY
Middle Name:RAY
Last Name:JONES
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 N VENTU PARK RD
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91320-2709
Mailing Address - Country:US
Mailing Address - Phone:805-375-4052
Mailing Address - Fax:
Practice Address - Street 1:550 N VENTU PARK RD
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91320-2709
Practice Address - Country:US
Practice Address - Phone:805-375-4052
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-14
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11376183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist