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General NPI Number Information
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NPI Number | 1366138943
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Entity Type | Organization
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Legal Business Name | BROTHERS PHARMACY LLC
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Dates
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Enumeration Date | 04/17/2023
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Last Update Date | 04/17/2023
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Provider Practice Location Address
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Address Line | 6200 LESLIE LN
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City | LAKE CHARLES
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State | LA
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Zip | 70615-4772
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Country | US
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Telephone | 877-264-8060
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Fax |
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Provider Business Mailing Address
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Address Line | 11705 SLATE AVE STE 200
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City | RIVERSIDE
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State | CA
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Zip | 92505-5199
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Country | US
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Telephone | 951-809-4011
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT OF REIMBURSEMENT
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Name | JENNIFER ARNOLD
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Credential |
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Telephone | 951-809-4011
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336H0001X
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Taxonomy Name | Home Infusion Therapy Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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