Provider Demographics
NPI:1831367002
Name:BRAMHALL, JOHN W JR (PHARMACIST)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:W
Last Name:BRAMHALL
Suffix:JR
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:331 WESTMONT DR
Mailing Address - Street 2:
Mailing Address - City:COLLINGDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19023-1023
Mailing Address - Country:US
Mailing Address - Phone:610-583-6676
Mailing Address - Fax:
Practice Address - Street 1:420 MACDADE BLVD
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:PA
Practice Address - Zip Code:19033-2513
Practice Address - Country:US
Practice Address - Phone:610-586-3117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-11
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP027298L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARP027298LOtherSTATE LICENSE #