Provider Demographics
NPI:1093060154
Name:BROOKHART, ANDREA LEIGH (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:LEIGH
Last Name:BROOKHART
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 1:4816 S LABURNUM AVE
Mailing Address - Street 2:ATTN: KROGER PHARMACY DEPARTMENT
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23231-2714
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4816 S LABURNUM AVE
Practice Address - Street 2:ATTN: KROGER PHARMACY DEPARTMENT
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23231-2714
Practice Address - Country:US
Practice Address - Phone:804-222-0240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-16
Last Update Date:2012-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202211475183500000X
OH03132017-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist