Provider Demographics
NPI:1043573108
Name:TOLIVER, BRENDIA THOMAS (PHARMD)
Entity Type:Individual
Prefix:
First Name:BRENDIA
Middle Name:THOMAS
Last Name:TOLIVER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:655 W 8TH ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32209-6511
Mailing Address - Country:US
Mailing Address - Phone:904-244-4157
Mailing Address - Fax:904-244-4272
Practice Address - Street 1:655 W 8TH ST
Practice Address - Street 2:SHANDS JACKSONVILLE DEPT. OF PHARMACY
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32209-6511
Practice Address - Country:US
Practice Address - Phone:904-244-4157
Practice Address - Fax:904-244-4272
Is Sole Proprietor?:No
Enumeration Date:2012-06-22
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS353311835P0018X, 1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist