Provider Demographics
NPI:1548587355
Name:BRASSINGTON, DEBORAH ANN (RPH)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:ANN
Last Name:BRASSINGTON
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 1:1123 PEARL ST
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301-5406
Mailing Address - Country:US
Mailing Address - Phone:508-588-4600
Mailing Address - Fax:
Practice Address - Street 1:1123 PEARL ST
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-5406
Practice Address - Country:US
Practice Address - Phone:508-588-4600
Practice Address - Fax:800-345-7741
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-03
Last Update Date:2010-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH232111835G0303X, 1835P0018X, 314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility