Provider Demographics
NPI:1144041088
Name:STEPHENS, BRANDON (PHARMD)
Entity type:Individual
Prefix:
First Name:BRANDON
Middle Name:
Last Name:STEPHENS
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 1:165 HALLOCK ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15211-1367
Mailing Address - Country:US
Mailing Address - Phone:724-882-3476
Mailing Address - Fax:
Practice Address - Street 1:1700 MURRAY AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15217-1604
Practice Address - Country:US
Practice Address - Phone:412-521-3900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-23
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP458157183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist