Provider Demographics
NPI:1063671964
Name:CRAIG, BRANDON M (PHARMD, RPH, BCACP)
Entity Type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:M
Last Name:CRAIG
Suffix:
Gender:M
Credentials:PHARMD, RPH, BCACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1090 ENTERPRISE DR
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-1328
Mailing Address - Country:US
Mailing Address - Phone:844-443-6879
Mailing Address - Fax:844-329-2447
Practice Address - Street 1:1090 ENTERPRISE DR
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-1328
Practice Address - Country:US
Practice Address - Phone:844-443-6879
Practice Address - Fax:844-329-2447
Is Sole Proprietor?:No
Enumeration Date:2008-06-05
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-2-28019183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH034590-0059Medicare PIN
OH2414640Medicaid