Provider Demographics
NPI:1619146636
Name:REXRODE BREWER, STACEY BROOKE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:STACEY
Middle Name:BROOKE
Last Name:REXRODE BREWER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7810 KATE BROWN DR
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-8330
Mailing Address - Country:US
Mailing Address - Phone:937-736-0893
Mailing Address - Fax:
Practice Address - Street 1:180 E SPRING VALLEY PIKE STE B
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45458-3803
Practice Address - Country:US
Practice Address - Phone:937-813-4888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-24
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-3-27037183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist