Provider Demographics
NPI:1376776674
Name:JOHNSON, BROOKE J (PHARMD)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:J
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:335 WASHINGTON RD
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-2701
Mailing Address - Country:US
Mailing Address - Phone:724-229-9306
Mailing Address - Fax:724-229-9306
Practice Address - Street 1:335 WASHINGTON RD
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-2701
Practice Address - Country:US
Practice Address - Phone:724-229-9306
Practice Address - Fax:724-229-9306
Is Sole Proprietor?:No
Enumeration Date:2009-09-02
Last Update Date:2009-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP439283183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist