MEDICARE: DR. BREANNA A LOCKE 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
1	183500000X	Pharmacist	031442	GA

General Provider Information

NPI Number	:	1942891692
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BREANNA A LOCKE PHARMD

Provider Business Mailing Address
First Line	:	1232 BELL HILL RD
Second Line	:
City	:	MURPHY
State	:	NC
Zip	:	28906-7328
Country	:	US
Telephone Number	:	828-557-0130
Fax Number	:

Provider Business Practice Location Address
First Line	:	178 BRACKETTS WAY STE 7
Second Line	:
City	:	BLAIRSVILLE
State	:	GA
Zip	:	30512-2984
Country	:	US
Telephone Number	:	706-400-5043
Fax Number	:	706-400-5046

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

Provider Enumeration Date	:	01/26/2021
Last Update Date	:	01/26/2021

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Directions to “ DR. BREANNA A LOCKE PHARMD” Practice Location

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