Provider Demographics
NPI:1609294123
Name:VEACH, BRETT (PHARMD)
Entity Type:Individual
Prefix:
First Name:BRETT
Middle Name:
Last Name:VEACH
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 W JEFFERSON ST
Mailing Address - Street 2:SUITE 140
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85003-2321
Mailing Address - Country:US
Mailing Address - Phone:602-296-7611
Mailing Address - Fax:602-358-8864
Practice Address - Street 1:50 W JEFFERSON ST
Practice Address - Street 2:SUITE 140
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85003-2321
Practice Address - Country:US
Practice Address - Phone:602-296-7611
Practice Address - Fax:602-358-8864
Is Sole Proprietor?:No
Enumeration Date:2014-04-01
Last Update Date:2014-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS020019183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist