Provider Demographics
NPI:1376995662
Name:BROOKS, LINDA ELAINE (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:ELAINE
Last Name:BROOKS
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21055 E RITTENHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-4477
Mailing Address - Country:US
Mailing Address - Phone:480-457-1882
Mailing Address - Fax:480-457-1884
Practice Address - Street 1:21055 E RITTENHOUSE RD
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85142-4477
Practice Address - Country:US
Practice Address - Phone:480-457-1822
Practice Address - Fax:480-457-1884
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-11
Last Update Date:2022-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX25604183500000X
AZS025823183500000X
COPHA.0019411183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist