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General NPI Number Information
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NPI Number | 1376982090
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Entity Type | Individual
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Provider Name | BRANDON CORPENING PHARMD
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Gender | Male
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Dates
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Enumeration Date | 06/15/2013
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Last Update Date | 09/26/2022
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Provider Practice Location Address
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Address Line | 3662 PARK AVE STE 155
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City | SAINT LOUIS
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State | MO
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Zip | 63110-2512
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Country | US
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Telephone | 314-897-5002
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Fax |
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Provider Business Mailing Address
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Address Line | 5742 GREY DOVE PL
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City | SAINT LOUIS
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State | MO
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Zip | 63128-3778
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Country | US
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Telephone | 404-593-9305
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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 | 1-117634
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License Number State | KS
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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 | 051301885
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License Number State | IL
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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 | 0202211411
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License Number State | VA
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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 | 2015036083
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License Number State | MO
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