William Luther Bennett | Stockton, CA • PECOS Search

William Luther Bennett

Pharmacist

Pharmacy Service Providers

1131 Sunnyoak Way, Stockton, CA 95209

PECOS Enrollment

Based on the most recent information from CMS, provider William Luther Bennett does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 34 days ago.

Profile Details

Provider ID
1104272954
Provider Type
Individual
Full Name
Bennett, William Luther
Title
Mr.
Credential
RPH

Gender
Male
Sole Proprietor
Yes
Enumeration Date
5/11/2016
Last Updated
5/11/2016

Contact Information

Practice Location

1131 Sunnyoak Way, Stockton, CA 95209

Unlisted Fax

Mailing Location

P.O. Box 690486, Stockton, CA 95269-0486

(209) 487-5349

Provider Taxonomies

Code	Description	License
Code 183500000X Primary	Description Pharmacist Pharmacy Service Providers	License 28245 California