Provider Demographics
NPI:1093145740
Name:HAMILTON, BRETT ALEXANDER (PHARM D)
Entity Type:Individual
Prefix:
First Name:BRETT
Middle Name:ALEXANDER
Last Name:HAMILTON
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 E BRIGHAM RD
Mailing Address - Street 2:APT 65
Mailing Address - City:SAINT GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-8436
Mailing Address - Country:US
Mailing Address - Phone:435-674-2820
Mailing Address - Fax:
Practice Address - Street 1:1050 E BRIGHAM RD
Practice Address - Street 2:APT 65
Practice Address - City:SAINT GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-8436
Practice Address - Country:US
Practice Address - Phone:435-674-2820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-16
Last Update Date:2013-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX54169183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist