Provider Demographics
NPI:1912473679
Name:RHOADS, BRANDON TAYLOR (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:TAYLOR
Last Name:RHOADS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 GLENWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:AR
Mailing Address - Zip Code:71655-5544
Mailing Address - Country:US
Mailing Address - Phone:501-539-2513
Mailing Address - Fax:
Practice Address - Street 1:427 HIGHWAY 425 N
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:AR
Practice Address - Zip Code:71655-4015
Practice Address - Country:US
Practice Address - Phone:501-539-2513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-21
Last Update Date:2018-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD12623183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty