Provider Demographics
NPI:1033713763
Name:BRANN, JAMES GRAFTON JR
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:GRAFTON
Last Name:BRANN
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9613 LYNDONWAY DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23229-3916
Mailing Address - Country:US
Mailing Address - Phone:804-399-8731
Mailing Address - Fax:
Practice Address - Street 1:9555 KINGS CHARTER DR STE D
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:VA
Practice Address - Zip Code:23005-7994
Practice Address - Country:US
Practice Address - Phone:844-650-1637
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-23
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202010668183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist