Dallas Ray Brooks, PHARMD
Individual provider Active NPI Pharmacist · Roxboro, NC
NPI 1609139682 · NPPES record last updated Jun 24, 2012
Key facts
- NPI
- 1609139682
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 22487 (NC)
- Practice address
- 304 N Madison Blvd
Roxboro, NC 27573-5355 - Phone
- (336) 599-0234
- NPI assigned
- Jun 24, 2012
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22487 | NC | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 22487 | NC | Yes |
Addresses
Primary practice location
304 N Madison Blvd
Roxboro, NC 27573-5355
Mailing address
7140 Helena Moriah Rd
Rougemont, NC 27572-7525
Phone (336) 364-2857
Other providers in Roxboro, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 24, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.