Provider Demographics
NPI:1477676385
Name:SPROWLES, BROOKE (PHARM D)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:
Last Name:SPROWLES
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 RUSTIC HAVEN DR
Mailing Address - Street 2:
Mailing Address - City:CAMPBELLSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42718-7633
Mailing Address - Country:US
Mailing Address - Phone:270-789-0995
Mailing Address - Fax:
Practice Address - Street 1:343 N WALLACE WILKINSON BLVD
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:KY
Practice Address - Zip Code:42539-3017
Practice Address - Country:US
Practice Address - Phone:606-787-5574
Practice Address - Fax:606-787-5604
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY013264183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist