Provider Demographics
NPI:1831583525
Name:DARBY, BROOKE
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:
Last Name:DARBY
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:BROOKE
Other - Middle Name:MICHELLE
Other - Last Name:FORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:785 COUNTY ROAD 277
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35633-4135
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1715 WOODWARD AVE
Practice Address - Street 2:
Practice Address - City:MUSCLE SHOALS
Practice Address - State:AL
Practice Address - Zip Code:35661-2254
Practice Address - Country:US
Practice Address - Phone:256-381-7641
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-20
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL19393183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist