Provider Demographics
NPI:1013217017
Name:WARD, BRETT (PHARMD)
Entity Type:Individual
Prefix:
First Name:BRETT
Middle Name:
Last Name:WARD
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 1:14200 PALM DR
Mailing Address - Street 2:
Mailing Address - City:DESERT HOT SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92240-6873
Mailing Address - Country:US
Mailing Address - Phone:760-329-1889
Mailing Address - Fax:760-251-4716
Practice Address - Street 1:14200 PALM DR
Practice Address - Street 2:
Practice Address - City:DESERT HOT SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92240-6873
Practice Address - Country:US
Practice Address - Phone:760-329-1889
Practice Address - Fax:760-251-4716
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
CA45402183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist