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NPI Code Detail

MEDICARE: TIMOTHY KELVIN BRANDON PHARMD

MEDICARE: TIMOTHY KELVIN BRANDON PHARMD
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
1183500000XPharmacist0202210057VA

General Provider Information

NPI Number : 1720688161
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIMOTHY KELVIN BRANDON PHARMD
Provider Business Mailing Address
First Line : 219 WOODBURN DR
Second Line :
City : HAMPTON
State : VA
Zip : 23664-1962
Country : US
Telephone Number : 757-593-4916
Fax Number :
Provider Business Practice Location Address
First Line : 2601 GEORGE WASHINGTON MEM HWY
Second Line :
City : YORKTOWN
State : VA
Zip : 23693-3409
Country : US
Telephone Number : 757-867-8281
Fax Number : 757-867-9580
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2020
Last Update Date : 10/26/2020

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