Provider Demographics
NPI:1336588391
Name:MARRYSHOW, BRETT JOSEPH ALBERT (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BRETT
Middle Name:JOSEPH ALBERT
Last Name:MARRYSHOW
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 1:2851 N GREEN VALLEY PKWY
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014-0402
Mailing Address - Country:US
Mailing Address - Phone:702-435-9849
Mailing Address - Fax:702-435-8520
Practice Address - Street 1:2851 N GREEN VALLEY PKWY
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-0402
Practice Address - Country:US
Practice Address - Phone:702-435-9849
Practice Address - Fax:702-435-8520
Is Sole Proprietor?:No
Enumeration Date:2013-06-22
Last Update Date:2013-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV18016183500000X
KY015027183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist