MEDICARE: BRANDON WEED

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	46411	TN

General Provider Information

NPI Number	:	1962130849
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRANDON WEED

Provider Business Mailing Address
First Line	:	1119 MINERAL WELLS AVE
Second Line	:
City	:	PARIS
State	:	TN
Zip	:	38242-4903
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1119 MINERAL WELLS AVE
Second Line	:
City	:	PARIS
State	:	TN
Zip	:	38242-4903
Country	:	US
Telephone Number	:	731-642-4092
Fax Number	:

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

Provider Enumeration Date	:	08/09/2022
Last Update Date	:	08/09/2022

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Directions to “ BRANDON WEED ” Practice Location

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