Brandon Paul Bourgeois, PHARMD, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

03236547 Issued in OH

Practice address

9400 Mentor Ave
Mentor, OH 44060-4520

Phone

(440) 255-6247

Fax

(440) 255-7203

NPI assigned

Jun 17, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy, Registered Pharmacist

State licenses

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

{
    "created_epoch": "1592352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592352000000",
    "number": "1184240962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9400 MENTOR AVE",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440604520",
            "telephone_number": "440-255-6247",
            "fax_number": "440-255-7203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9400 MENTOR AVE",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440604520",
            "telephone_number": "440-255-6247",
            "fax_number": "440-255-7203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURGEOIS",
        "first_name": "BRANDON",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "PHARMD, RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-17",
        "last_updated": "2020-06-17",
        "certification_date": "2020-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03236547",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO BOARD OF PHARMACY",
            "identifier": "03236547",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "n/a",
            "affiliation": "N",
            "address_1": "9400 Mentor Ave",
            "city": "Mentor",
            "state": "OH",
            "country_code": "US",
            "postal_code": "440604520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Robert E Botti Jr., M.D.
• Amanda Botts, MA
• Juliann Michelle Bouffard, RN
• Christine L Boulden, RN
• Janine Rene Bouldin, LSW
• Angela Marvita Bowden, LPN
• David Alan Bowe, MD
• Bowersox Wound Care LLC
• Harold Jonathan Bowersox, D.O.
• Rachael Bowman, RA

• Pharmacist in Mentor, OH
• Providers in Mentor, OH by specialty
• Pharmacist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2020; 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.