Healthcare Provider Details

I. General information

NPI: 1720499569
Provider Name (Legal Business Name): BRANDON CHARLES ANTINOPOULOS PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2014
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

998 3RD ST
BEAVER PA
15009-2025
US

IV. Provider business mailing address

998 3RD ST
BEAVER PA
15009-2025
US

V. Phone/Fax

Practice location:
  • Phone: 724-246-6257
  • Fax: 724-921-1806
Mailing address:
  • Phone: 724-246-6257
  • Fax: 724-921-1806

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP448568
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: