Provider Demographics
NPI:1083033070
Name:BREW, BELINDA
Entity Type:Individual
Prefix:
First Name:BELINDA
Middle Name:
Last Name:BREW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 FRANKLIN TPKE
Mailing Address - Street 2:APT H3
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24540-1495
Mailing Address - Country:US
Mailing Address - Phone:954-512-0591
Mailing Address - Fax:
Practice Address - Street 1:155 HOLT GARRISON PKWY
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24540-5947
Practice Address - Country:US
Practice Address - Phone:434-799-9950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-07
Last Update Date:2014-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202212535183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist