Provider Demographics
NPI:1649709585
Name:DONALDSON, BRANDY (PHARM D)
Entity type:Individual
Prefix:
First Name:BRANDY
Middle Name:
Last Name:DONALDSON
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:413 OAKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:OPP
Mailing Address - State:AL
Mailing Address - Zip Code:36467-9765
Mailing Address - Country:US
Mailing Address - Phone:334-701-3765
Mailing Address - Fax:
Practice Address - Street 1:112 N MAIN ST
Practice Address - Street 2:
Practice Address - City:ENTERPRISE
Practice Address - State:AL
Practice Address - Zip Code:36330-2537
Practice Address - Country:US
Practice Address - Phone:334-347-2506
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-05
Last Update Date:2017-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS404521835P0018X
AL147951835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL14795OtherAL BOARD OF PHARMACY
FLPS40452OtherFL STATE BOARD OF PHARMACY