MEDICARE: BRANDON J NIXON PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	26023320A	IN

General Provider Information

NPI Number	:	1316542186
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRANDON J NIXON PHARMD

Provider Business Mailing Address
First Line	:	220 S MEMORIAL DR
Second Line	:
City	:	NEW CASTLE
State	:	IN
Zip	:	47362-4948
Country	:	US
Telephone Number	:	765-529-9209
Fax Number	:	765-521-3807

Provider Business Practice Location Address
First Line	:	220 S MEMORIAL DR
Second Line	:
City	:	NEW CASTLE
State	:	IN
Zip	:	47362-4948
Country	:	US
Telephone Number	:	765-529-9209
Fax Number	:	765-521-3807

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/01/2020
Last Update Date	:	12/01/2020

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