Provider Demographics
NPI:1376731604
Name:BRUMAND, MARY (R PH)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:BRUMAND
Suffix:
Gender:F
Credentials:R PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6933 W LAREDO ST
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85226-1630
Mailing Address - Country:US
Mailing Address - Phone:480-705-0112
Mailing Address - Fax:480-699-2610
Practice Address - Street 1:2501 S MARKET ST
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295-1300
Practice Address - Country:US
Practice Address - Phone:480-224-6911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-11
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ10775183500000X
CT6113183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist