Provider Demographics
NPI:1356039085
Name:CARVEY, BRANDON MICHAEL (RPH)
Entity type:Individual
Prefix:MR
First Name:BRANDON
Middle Name:MICHAEL
Last Name:CARVEY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1672 E BROOKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:WEST BRANCH
Mailing Address - State:MI
Mailing Address - Zip Code:48661-9504
Mailing Address - Country:US
Mailing Address - Phone:616-438-3020
Mailing Address - Fax:
Practice Address - Street 1:729 W HOUGHTON LAKE DR
Practice Address - Street 2:
Practice Address - City:PRUDENVILLE
Practice Address - State:MI
Practice Address - Zip Code:48651-8462
Practice Address - Country:US
Practice Address - Phone:989-366-5324
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-01
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302415092183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist