Provider Demographics
NPI:1366485591
Name:STOGDILL, BRENT S (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BRENT
Middle Name:S
Last Name:STOGDILL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:531 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81401-3931
Mailing Address - Country:US
Mailing Address - Phone:970-252-1760
Mailing Address - Fax:970-240-4276
Practice Address - Street 1:531 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401-3931
Practice Address - Country:US
Practice Address - Phone:970-252-1760
Practice Address - Fax:970-240-4276
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO15974183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist