Provider Demographics
NPI:1831680479
Name:GERLEMAN, BRANDON LOREN
Entity Type:Individual
Prefix:
First Name:BRANDON
Middle Name:LOREN
Last Name:GERLEMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 N 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:WINTERSET
Mailing Address - State:IA
Mailing Address - Zip Code:50273-1594
Mailing Address - Country:US
Mailing Address - Phone:515-462-2282
Mailing Address - Fax:515-462-2296
Practice Address - Street 1:118 N 1ST AVE
Practice Address - Street 2:
Practice Address - City:WINTERSET
Practice Address - State:IA
Practice Address - Zip Code:50273-1594
Practice Address - Country:US
Practice Address - Phone:515-462-2282
Practice Address - Fax:515-462-2296
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-18
Last Update Date:2018-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA230351835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care