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General NPI Number Information
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NPI Number | 1750648473
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Entity Type | Individual
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Provider Name | JAMES JEROME BREHANY III BS, PHARMD
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Gender | Male
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Dates
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Enumeration Date | 04/19/2012
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Last Update Date | 04/19/2012
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Provider Practice Location Address
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Address Line | 200 STEVENS DR 4TH FLOOR, PHARMACY SERVICES
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City | PHILADELPHIA
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State | PA
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Zip | 19113-1522
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Country | US
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Telephone | 352-216-6629
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Fax |
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Provider Business Mailing Address
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Address Line | 2152 NW 165TH ST
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City | CITRA
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State | FL
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Zip | 32113-2931
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Country | US
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Telephone |
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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 | 07099
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License Number State | NV
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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 | 31287
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License Number State | CA
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