Provider Demographics
NPI:1982830931
Name:LIBMAN, BRENDA G (RPH)
Entity Type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:G
Last Name:LIBMAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:286 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ANDREWS
Mailing Address - State:NC
Mailing Address - Zip Code:28901-9250
Mailing Address - Country:US
Mailing Address - Phone:828-321-5801
Mailing Address - Fax:828-321-9304
Practice Address - Street 1:286 MAIN ST
Practice Address - Street 2:
Practice Address - City:ANDREWS
Practice Address - State:NC
Practice Address - Zip Code:28901-9250
Practice Address - Country:US
Practice Address - Phone:828-321-5801
Practice Address - Fax:828-321-9304
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-04
Last Update Date:2009-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16170183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist