Provider Demographics
NPI:1982267712
Name:BROOKS, DENNIS (PHARMD)
Entity type:Individual
Prefix:
First Name:DENNIS
Middle Name:
Last Name:BROOKS
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:DENNIS BROOKS
Mailing Address - Street 2:990 E. COLLEGE ST.
Mailing Address - City:BATESVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72501
Mailing Address - Country:US
Mailing Address - Phone:870-834-9139
Mailing Address - Fax:
Practice Address - Street 1:WHITE RIVER MEDICAL CENTER
Practice Address - Street 2:1710 HARRISON ST.
Practice Address - City:BATESVILLE
Practice Address - State:AR
Practice Address - Zip Code:72501
Practice Address - Country:US
Practice Address - Phone:870-262-1273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-17
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD07103183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARPD07103OtherSTATE BOARD OF PHARMACY