Provider Demographics
NPI:1861630014
Name:BROOKS, ANTHONY JOSEPH (RPH)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:JOSEPH
Last Name:BROOKS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 COVE VIEW LANE
Mailing Address - Street 2:BOX 532
Mailing Address - City:COBBS CREEK
Mailing Address - State:VA
Mailing Address - Zip Code:23035
Mailing Address - Country:US
Mailing Address - Phone:804-725-0538
Mailing Address - Fax:
Practice Address - Street 1:2 COVE VIEW LANE
Practice Address - Street 2:BOX 532
Practice Address - City:COBBS CREEK
Practice Address - State:VA
Practice Address - Zip Code:23035
Practice Address - Country:US
Practice Address - Phone:804-725-0538
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-27
Last Update Date:2009-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202207834183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist