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General NPI Number Information
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NPI Number | 1265479778
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Entity Type | Organization
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Legal Business Name | BRANDON JONES INC
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Dates
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Enumeration Date | 06/01/2006
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Last Update Date | 10/02/2014
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Provider Practice Location Address
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Address Line | 241 BILLY DYAR BLVD
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City | BOAZ
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State | AL
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Zip | 35957-7102
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Country | US
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Telephone | 256-840-1100
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Fax | 256-840-1119
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Provider Business Mailing Address
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Address Line | 241 BILLY DYAR BLVD
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City | BOAZ
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State | AL
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Zip | 35957-7102
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Country | US
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Telephone | 256-840-1100
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Fax | 256-840-1119
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Authorized Official
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Title or Position | OWNER/PHARMACIST
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Name | BRANDON JONES
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Credential |
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Telephone | 256-840-1100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 112383
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License Number State | AL
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