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General NPI Number Information
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NPI Number | 1619146636
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Entity Type | Individual
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Provider Name | STACEY BROOKE REXRODE BREWER PHARMD
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Gender | Female
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Dates
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Enumeration Date | 02/24/2008
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Last Update Date | 06/28/2022
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Provider Practice Location Address
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Address Line | 180 E SPRING VALLEY PIKE STE B
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City | DAYTON
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State | OH
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Zip | 45458-3803
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Country | US
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Telephone | 937-813-4888
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Fax |
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Provider Business Mailing Address
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Address Line | 7810 KATE BROWN DR
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City | DUBLIN
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State | OH
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Zip | 43017-8330
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Country | US
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Telephone | 937-736-0893
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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 | 03-3-27037
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License Number State | OH
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