Healthcare Provider Details

I. General information

NPI: 1265341275
Provider Name (Legal Business Name): BRENDA MANNI PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28550 CABOT DR STE 200
NOVI MI
48377-2988
US

IV. Provider business mailing address

7891 TIMBERLANE TRL
WEST BLOOMFIELD MI
48323-4012
US

V. Phone/Fax

Practice location:
  • Phone: 866-425-2550
  • Fax:
Mailing address:
  • Phone: 248-346-1997
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number26218110856
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: