Provider Demographics
NPI:1245561844
Name:KURZ, BRANDON MITCHELL (RPH)
Entity Type:Individual
Prefix:
First Name:BRANDON
Middle Name:MITCHELL
Last Name:KURZ
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4006 E BELL RD
Mailing Address - Street 2:WALGREENS
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-2232
Mailing Address - Country:US
Mailing Address - Phone:602-971-1312
Mailing Address - Fax:602-971-5344
Practice Address - Street 1:4006 E BELL RD
Practice Address - Street 2:WALGREENS
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-2232
Practice Address - Country:US
Practice Address - Phone:602-971-1312
Practice Address - Fax:602-971-5344
Is Sole Proprietor?:No
Enumeration Date:2010-01-21
Last Update Date:2010-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS011182183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist