Healthcare Provider Details

I. General information

NPI: 1528492709
Provider Name (Legal Business Name): ROBERT JAMES BRENNER III PHARM D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2013
Last Update Date: 12/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 E NORTH AVE STE 111
PITTSBURGH PA
15212-4756
US

IV. Provider business mailing address

320 E NORTH AVE STE 111
PITTSBURGH PA
15212-4756
US

V. Phone/Fax

Practice location:
  • Phone: 412-359-8677
  • Fax:
Mailing address:
  • Phone: 412-359-8677
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number21886
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: