Provider Demographics
NPI:1588964530
Name:BROOKS, BRANDI L (PHARMD)
Entity type:Individual
Prefix:DR
First Name:BRANDI
Middle Name:L
Last Name:BROOKS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:286 COUNTY ROAD 7030
Mailing Address - Street 2:
Mailing Address - City:BOONEVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:38829-9521
Mailing Address - Country:US
Mailing Address - Phone:662-284-6344
Mailing Address - Fax:
Practice Address - Street 1:104 HIGHWAY 72 W
Practice Address - Street 2:
Practice Address - City:CORINTH
Practice Address - State:MS
Practice Address - Zip Code:38834-5511
Practice Address - Country:US
Practice Address - Phone:662-287-8304
Practice Address - Fax:662-287-8245
Is Sole Proprietor?:No
Enumeration Date:2010-10-25
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-09995183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist