Provider Demographics
NPI:1902218860
Name:FOSTER, BRANDY (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:BRANDY
Middle Name:
Last Name:FOSTER
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2305 JONESBORO RD
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-5999
Mailing Address - Country:US
Mailing Address - Phone:770-957-5864
Mailing Address - Fax:770-957-2482
Practice Address - Street 1:2305 JONESBORO RD
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253-5999
Practice Address - Country:US
Practice Address - Phone:770-957-5864
Practice Address - Fax:770-957-2482
Is Sole Proprietor?:No
Enumeration Date:2014-05-27
Last Update Date:2014-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH026674183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist