MEDICARE: BRANDON MCCREA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	03337256	OH

General Provider Information

NPI Number	:	1356812861
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRANDON MCCREA

Provider Business Mailing Address
First Line	:	304 GLENSFORD CT
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45246-2376
Country	:	US
Telephone Number	:	513-532-2723
Fax Number	:

Provider Business Practice Location Address
First Line	:	4777 KENARD AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45232-1992
Country	:	US
Telephone Number	:	513-681-7916
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/10/2018
Last Update Date	:	12/10/2018

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Directions to “ BRANDON MCCREA ” Practice Location

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