Provider Demographics
NPI:1912495268
Name:DOMAGALSKI, BRITTANY M (PHARMD)
Entity type:Individual
Prefix:DR
First Name:BRITTANY
Middle Name:M
Last Name:DOMAGALSKI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:113 E US HIGHWAY 54
Mailing Address - Street 2:
Mailing Address - City:CAMDENTON
Mailing Address - State:MO
Mailing Address - Zip Code:65020-7320
Mailing Address - Country:US
Mailing Address - Phone:573-346-3396
Mailing Address - Fax:573-346-5257
Practice Address - Street 1:113 E US HIGHWAY 54
Practice Address - Street 2:
Practice Address - City:CAMDENTON
Practice Address - State:MO
Practice Address - Zip Code:65020-7320
Practice Address - Country:US
Practice Address - Phone:573-346-3396
Practice Address - Fax:573-346-5257
Is Sole Proprietor?:No
Enumeration Date:2018-04-23
Last Update Date:2018-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016026612183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist