Provider Demographics
NPI:1235927989
Name:BROTHERHOOD PHARMACY INC
Entity type:Organization
Organization Name:BROTHERHOOD PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:YONGMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-222-4884
Mailing Address - Street 1:1040 S MOUNT VERNON AVE STE E
Mailing Address - Street 2:
Mailing Address - City:COLTON
Mailing Address - State:CA
Mailing Address - Zip Code:92324-4228
Mailing Address - Country:US
Mailing Address - Phone:909-222-4884
Mailing Address - Fax:909-222-4921
Practice Address - Street 1:1040 S MOUNT VERNON AVE STE E
Practice Address - Street 2:
Practice Address - City:COLTON
Practice Address - State:CA
Practice Address - Zip Code:92324-4228
Practice Address - Country:US
Practice Address - Phone:909-222-4884
Practice Address - Fax:909-222-4921
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-30
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy