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NPI Code Detail

MEDICARE: BRANDY SUZANNE TEMPLE PHARM.D.

MEDICARE: BRANDY SUZANNE TEMPLE PHARM.D.
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
1183500000XPharmacist16960NV

General Provider Information

NPI Number : 1730291774
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRANDY SUZANNE TEMPLE PHARM.D.
Provider Business Mailing Address
First Line : 8447 AMHERST VALLEY ST
Second Line :
City : LAS VEGAS
State : NV
Zip : 89123-2474
Country : US
Telephone Number : 702-767-8113
Fax Number :
Provider Business Practice Location Address
First Line : 4700 LAS VEGAS BLVD N
Second Line : NELLIS AIR FORCE BASE
City : LAS VEGAS
State : NV
Zip : 89191-6600
Country : US
Telephone Number : 702-653-3212
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 07/08/2007

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