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General NPI Number Information
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NPI Number | 1669809810
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Entity Type | Individual
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Provider Name | BRANDON LEE SMITH PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 10/02/2013
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Last Update Date | 12/05/2019
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Provider Practice Location Address
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Address Line | 8300 NORMAN CENTER DR SUITE 800
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City | BLOOMINGTON
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State | MN
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Zip | 55437-1027
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Country | US
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Telephone | 612-297-7308
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Fax |
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Provider Business Mailing Address
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Address Line | 16633 90TH AVE N
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City | MAPLE GROVE
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State | MN
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Zip | 55311-1559
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Country | US
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Telephone | 612-750-3083
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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 | 121334
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License Number State | MN
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