Provider Demographics
NPI:1497359475
Name:JOHNSTON, BRANDY MARIE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:BRANDY
Middle Name:MARIE
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8028 MARTIN FIELD DR
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23111-6483
Mailing Address - Country:US
Mailing Address - Phone:804-432-7771
Mailing Address - Fax:
Practice Address - Street 1:7048 MECHANICSVILLE TPKE
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23111-7101
Practice Address - Country:US
Practice Address - Phone:804-730-9498
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202209621183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist