Provider Demographics
NPI:1497740286
Name:WOOD, BRENDA (PHARMD, BPHARM)
Entity Type:Individual
Prefix:MS
First Name:BRENDA
Middle Name:
Last Name:WOOD
Suffix:
Gender:F
Credentials:PHARMD, BPHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2217 PLAZA DRIVE
Mailing Address - Street 2:
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95765
Mailing Address - Country:US
Mailing Address - Phone:800-872-8276
Mailing Address - Fax:916-352-6293
Practice Address - Street 1:5109 W LEMON ST STE A
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-1102
Practice Address - Country:US
Practice Address - Phone:813-463-1251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-16
Last Update Date:2011-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS41030183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist