Provider Demographics
NPI:1316632649
Name:BRAND, KENT (PHARMD)
Entity type:Individual
Prefix:
First Name:KENT
Middle Name:
Last Name:BRAND
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6223 N BROADWAY AVE
Mailing Address - Street 2:
Mailing Address - City:PARK CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67219-1101
Mailing Address - Country:US
Mailing Address - Phone:316-744-3948
Mailing Address - Fax:316-744-9801
Practice Address - Street 1:6223 N BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:PARK CITY
Practice Address - State:KS
Practice Address - Zip Code:67219-1101
Practice Address - Country:US
Practice Address - Phone:316-744-3948
Practice Address - Fax:316-744-9801
Is Sole Proprietor?:No
Enumeration Date:2023-04-11
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-14004183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist