Provider Demographics
NPI:1346357134
Name:BRUMMER, JOSEPH G (RPH)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:G
Last Name:BRUMMER
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 1:202 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ANTHONY
Mailing Address - State:KS
Mailing Address - Zip Code:67003-2728
Mailing Address - Country:US
Mailing Address - Phone:620-842-5119
Mailing Address - Fax:620-842-3184
Practice Address - Street 1:202 W MAIN ST
Practice Address - Street 2:
Practice Address - City:ANTHONY
Practice Address - State:KS
Practice Address - Zip Code:67003-2728
Practice Address - Country:US
Practice Address - Phone:620-842-5119
Practice Address - Fax:620-842-3184
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS9650183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist