| NPI | 1346833829 |
|---|---|
| Former Legal Business Name | NORTH BENTON HEALTH CARE, INC |
| Entity Type | Organization |
| Authorized Contact | BLU G STONZ CEO 662-224-8951 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2021-02-16 |
| Last Update Date | 2023-12-05 |