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General NPI Number Information
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NPI Number | 1215701057
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Entity Type | Individual
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Provider Name | BRANDON R ENGHAUSER PHARM. D.
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Gender | Male
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Dates
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Enumeration Date | 11/13/2023
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Last Update Date | 11/13/2023
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Provider Practice Location Address
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Address Line | 345 DUNN RD
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City | FLORISSANT
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State | MO
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Zip | 63031-7929
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Country | US
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Telephone | 314-921-4242
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Fax |
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Provider Business Mailing Address
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Address Line | 345 DUNN RD
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City | FLORISSANT
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State | MO
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Zip | 63031-7929
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Country | US
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Telephone | 314-921-4242
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 051299330
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS54513
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH27546
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License Number State | MA
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Taxonomy #4
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 2010026495
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License Number State | MO
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