Provider Demographics
NPI:1497350318
Name:RAMON, BRANDON THOMAS (PHARMD, MBA)
Entity Type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:THOMAS
Last Name:RAMON
Suffix:
Gender:M
Credentials:PHARMD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 W CARO RD
Mailing Address - Street 2:
Mailing Address - City:CARO
Mailing Address - State:MI
Mailing Address - Zip Code:48723-9260
Mailing Address - Country:US
Mailing Address - Phone:989-878-1079
Mailing Address - Fax:
Practice Address - Street 1:1520 W CARO RD
Practice Address - Street 2:
Practice Address - City:CARO
Practice Address - State:MI
Practice Address - Zip Code:48723-9260
Practice Address - Country:US
Practice Address - Phone:989-673-7020
Practice Address - Fax:866-317-9946
Is Sole Proprietor?:No
Enumeration Date:2020-11-30
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302411931183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5302411931OtherSTATE OF MICHIGAN DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS
MI5315212910OtherSTATE OF MICHIGAN DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS CS LICENSE