Provider Demographics
NPI:1871184440
Name:DAVIDSON, BRANDON (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:
Last Name:DAVIDSON
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 1:1500 N FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24073-1412
Mailing Address - Country:US
Mailing Address - Phone:540-381-9345
Mailing Address - Fax:540-381-9346
Practice Address - Street 1:1500 N FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:CHRISTIANSBURG
Practice Address - State:VA
Practice Address - Zip Code:24073-1412
Practice Address - Country:US
Practice Address - Phone:540-381-9345
Practice Address - Fax:540-381-9346
Is Sole Proprietor?:No
Enumeration Date:2021-01-27
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202216309183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist