Provider Demographics
NPI:1346863636
Name:BRYAN PHARMACY LLC
Entity Type:Organization
Organization Name:BRYAN PHARMACY LLC
Other - Org Name:BRYAN PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORIUS
Authorized Official - Middle Name:M
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:979-399-5899
Mailing Address - Street 1:3926 AVENUE H STE 2
Mailing Address - Street 2:
Mailing Address - City:ROSENBERG
Mailing Address - State:TX
Mailing Address - Zip Code:77471-2842
Mailing Address - Country:US
Mailing Address - Phone:979-399-5899
Mailing Address - Fax:979-399-5899
Practice Address - Street 1:3926 AVENUE H STE 2
Practice Address - Street 2:
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77471-2842
Practice Address - Country:US
Practice Address - Phone:979-399-5899
Practice Address - Fax:979-399-5899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-21
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy