Provider Demographics
NPI:1932590635
Name:BRANDON, JIMMIE LYNN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JIMMIE
Middle Name:LYNN
Last Name:BRANDON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3141 GARDEN RD
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-9786
Mailing Address - Country:US
Mailing Address - Phone:336-584-1133
Mailing Address - Fax:336-584-4136
Practice Address - Street 1:3141 GARDEN RD
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-9786
Practice Address - Country:US
Practice Address - Phone:336-584-1133
Practice Address - Fax:336-584-4136
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-17
Last Update Date:2015-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12491183500000X
SC7985183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist