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General NPI Number Information
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NPI Number | 1639434483
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Entity Type | Individual
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Provider Name | BARRY BREWER R.PH.
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Gender | Male
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Dates
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Enumeration Date | 07/09/2012
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Last Update Date | 07/09/2012
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Provider Practice Location Address
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Address Line | 225 N EAGLE ST
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City | OSHKOSH
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State | WI
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Zip | 54902-4125
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Country | US
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Telephone | 920-966-1345
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Fax | 920-966-1285
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Provider Business Mailing Address
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Address Line | 3421 N CHAPPELL DR
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City | APPLETON
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State | WI
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Zip | 54914-6890
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Country | US
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Telephone | 920-730-0799
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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 | 9939-040
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License Number State | WI
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