Provider Demographics
NPI:1972035236
Name:BROOKSVILLE PHARMACEUTICALS INC
Entity Type:Organization
Organization Name:BROOKSVILLE PHARMACEUTICALS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CLURMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:352-848-3446
Mailing Address - Street 1:16140 FLIGHT PATH DR
Mailing Address - Street 2:
Mailing Address - City:BROOKSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:34604-6845
Mailing Address - Country:US
Mailing Address - Phone:352-848-3446
Mailing Address - Fax:352-848-3445
Practice Address - Street 1:16140 FLIGHT PATH DR
Practice Address - Street 2:
Practice Address - City:BROOKSVILLE
Practice Address - State:FL
Practice Address - Zip Code:34604-6845
Practice Address - Country:US
Practice Address - Phone:352-848-3446
Practice Address - Fax:352-848-3445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-28
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH307083336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy