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NPI Code Detail

MEDICARE: CRAIG BRUBAKER PHARMD

MEDICARE:   CRAIG  BRUBAKER  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
1183500000XPharmacistPS48950FL

General Provider Information

NPI Number : 1356688402
Entity Type Code : Individual
Provider Name (Legal Business Name) : CRAIG BRUBAKER PHARMD
Provider Business Mailing Address
First Line : 731 DUVAL STATION RD
Second Line : STE 4
City : JACKSONVILLE
State : FL
Zip : 32218-0800
Country : US
Telephone Number : 904-696-3363
Fax Number :
Provider Business Practice Location Address
First Line : 731 DUVAL STATION RD
Second Line : STE 4
City : JACKSONVILLE
State : FL
Zip : 32218-0800
Country : US
Telephone Number : 904-696-3363
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2013
Last Update Date : 01/09/2013

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Directions to “ CRAIG BRUBAKER PHARMD” Practice Location

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