Provider Demographics
NPI:1205413036
Name:PICHE, BRENDA J
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:J
Last Name:PICHE
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 1:12 HOWARD RD
Mailing Address - Street 2:
Mailing Address - City:WARE
Mailing Address - State:MA
Mailing Address - Zip Code:01082-9315
Mailing Address - Country:US
Mailing Address - Phone:413-813-4135
Mailing Address - Fax:
Practice Address - Street 1:352 PALMER RD
Practice Address - Street 2:
Practice Address - City:WARE
Practice Address - State:MA
Practice Address - Zip Code:01082-9740
Practice Address - Country:US
Practice Address - Phone:413-967-0044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-26
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician