Provider Demographics
NPI:1083378897
Name:BRANDON, AMBER (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:AMBER
Middle Name:
Last Name:BRANDON
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 1:3775 E SIMPSON CT
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85297-8283
Mailing Address - Country:US
Mailing Address - Phone:480-406-0402
Mailing Address - Fax:
Practice Address - Street 1:1444 S SOSSAMAN RD
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85209-3400
Practice Address - Country:US
Practice Address - Phone:480-333-6559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-27
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS025458183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist