Provider Demographics
NPI:1184908923
Name:RAYMOND, BROOKE D (PHARMD)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:D
Last Name:RAYMOND
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:273 BELMONT ST
Mailing Address - Street 2:APT 2
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-4454
Mailing Address - Country:US
Mailing Address - Phone:603-361-3974
Mailing Address - Fax:
Practice Address - Street 1:606 VALLEY ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103-4305
Practice Address - Country:US
Practice Address - Phone:603-668-7924
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-28
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3791183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist