Healthcare Provider Details

I. General information

NPI: 1336257773
Provider Name (Legal Business Name): MICHAEL THOMAS BRENNAN PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2006
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 S HUNTINGTON AVE
BOSTON MA
02130-4817
US

IV. Provider business mailing address

150 S HUNTINGTON AVE
BOSTON MA
02130-4817
US

V. Phone/Fax

Practice location:
  • Phone: 857-364-5033
  • Fax: 857-364-5337
Mailing address:
  • Phone: 857-364-5033
  • Fax: 857-364-5337

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number26168
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number26168
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: