Provider Demographics
NPI:1750648473
Name:BREHANY, JAMES JEROME III (BS, PHARMD)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:JEROME
Last Name:BREHANY
Suffix:III
Gender:M
Credentials:BS, PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2152 NW 165TH ST
Mailing Address - Street 2:
Mailing Address - City:CITRA
Mailing Address - State:FL
Mailing Address - Zip Code:32113-2931
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 STEVENS DR
Practice Address - Street 2:4TH FLOOR, PHARMACY SERVICES
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19113-1522
Practice Address - Country:US
Practice Address - Phone:352-216-6629
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-19
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV07099183500000X
CA31287183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist