| Organization Name: | JUDY J BENTON |
| NPI Number: | 1013187079 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JUDY J BENTON (SOLE PROPRIETOR) |
| Mailing Address: | 1705 Leighton Ave Anniston |
| State: | AL US |
| Postal Code: | 362073832 |
| Phone Number: | 2562352524 |
| Fax Number: | 2562362573 |
| NPI Enumeration Date: | 03/06/2008 |
| NPI Last Update Date: | 06/17/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BC3200X |
| License Number: | PTH1017 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AL |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Customized Equipment |
| Taxonomy Definition: | |