Provider Demographics
NPI:1649240797
Name:HARRISON, BRIAN PATRICK (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:PATRICK
Last Name:HARRISON
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 1:10606 SANTORINI CT
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32507
Mailing Address - Country:US
Mailing Address - Phone:850-384-8130
Mailing Address - Fax:850-494-9077
Practice Address - Street 1:4711 BAYOU BLVD
Practice Address - Street 2:PHARMACY DEPARTMENT
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-2607
Practice Address - Country:US
Practice Address - Phone:850-494-9077
Practice Address - Fax:850-494-9077
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS 40833183500000X
IA19912183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist