Provider Demographics
NPI:1720411903
Name:ENGLAND, BRANDYN TYLER (PHARMD)
Entity Type:Individual
Prefix:
First Name:BRANDYN
Middle Name:TYLER
Last Name:ENGLAND
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 1:1640 S WHITEHEAD DR
Mailing Address - Street 2:
Mailing Address - City:DE WITT
Mailing Address - State:AR
Mailing Address - Zip Code:72042-2994
Mailing Address - Country:US
Mailing Address - Phone:870-946-2381
Mailing Address - Fax:
Practice Address - Street 1:1640 S WHITEHEAD DR
Practice Address - Street 2:
Practice Address - City:DE WITT
Practice Address - State:AR
Practice Address - Zip Code:72042-2994
Practice Address - Country:US
Practice Address - Phone:870-946-2381
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-12
Last Update Date:2013-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD12301183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist