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General NPI Number Information
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NPI Number | 1811270408
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Entity Type | Individual
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Provider Name | KENNETH RANDY BRAMMER RPH
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Gender | Male
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Dates
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Enumeration Date | 09/21/2011
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Last Update Date | 09/21/2011
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Provider Practice Location Address
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Address Line | 100 12TH AVE NE
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City | NORMAN
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State | OK
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Zip | 73071-5235
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Country | US
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Telephone | 405-329-2314
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Fax | 405-329-2405
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Provider Business Mailing Address
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Address Line | 2716 SW 139TH ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73170-5784
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Country | US
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Telephone | 405-692-5929
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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 | 12934
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License Number State | OK
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