Healthcare Provider Details

I. General information

NPI: 1659822302
Provider Name (Legal Business Name): BROOK BRIEL MAY COLLINS PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BROOK BRIEL MAY GOULD

II. Dates (important events)

Enumeration Date: 10/18/2016
Last Update Date: 08/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46314 TIMINE WAY
PENDLETON OR
97801
US

IV. Provider business mailing address

1239 NW HORN AVE
PENDLETON OR
97801-1253
US

V. Phone/Fax

Practice location:
  • Phone: 541-278-7546
  • Fax:
Mailing address:
  • Phone: 406-980-0303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number15676
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: