Brandon V Thach

Primary specialty

PharmacistTaxonomy code 183500000X

License

PS39614 Issued in FL

Practice address

160 Mariner Blvd
160 Mariner Blvd
Spring Hill, FL 34609-5689

Phone

(352) 688-2305

Fax

(352) 666-2122

NPI assigned

Jan 9, 2013

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Brandon V Thach Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1357689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357689600000",
    "number": "1013254176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 MARINER BLVD",
            "address_2": "160 MARINER BLVD",
            "city": "SPRING HILL",
            "state": "FL",
            "postal_code": "346095689",
            "telephone_number": "352-688-2305",
            "fax_number": "352-666-2122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 MARINER BLVD",
            "address_2": "160 MARINER BLVD",
            "city": "SPRING HILL",
            "state": "FL",
            "postal_code": "346095689",
            "telephone_number": "352-688-2305",
            "fax_number": "352-666-2122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THACH",
        "first_name": "BRANDON",
        "middle_name": "V",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-09",
        "last_updated": "2013-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS39614",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "PH23820",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRANDON",
            "last_name": "THACH",
            "middle_name": "V",
            "credential": "RPH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Pharmacist in Spring Hill, FL
• Providers in Spring Hill, FL by specialty
• Pharmacist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.