Brandy Pharmacy Corp

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

BRANDY PHARMACY CORP

Practice address

2241 Peggy LN Ste B
Garland, TX 75042-5709

Phone

(972) 272-6300

Fax

(972) 272-6311

NPI assigned

Sep 29, 2015

Organization subpart

No

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

Authorized official

Name

Nedal Naser

Title

President

Phone

(972) 992-8205

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Brandy Pharmacy Doing business as

Tax ID family

Brandy Pharmacy3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Brandy Pharmacy Corp

  • Community/Retail Pharmacy
  • Mesquite, TX
  • NPI 1194261024
  NPD tax ID
• Brandy Pharmacy Corp

  • Pharmacy
  • Mesquite, TX
  • NPI 1497231328
  NPD tax ID

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

{
    "created_epoch": "1443484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581552000000",
    "number": "1902276231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 851766",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751851766",
            "telephone_number": "214-707-9971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2241 PEGGY LN STE B",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750425709",
            "telephone_number": "972-272-6300",
            "fax_number": "972-272-6311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRANDY PHARMACY CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-29",
        "last_updated": "2020-02-13",
        "certification_date": "2020-02-13",
        "status": "A",
        "authorized_official_last_name": "NASER",
        "authorized_official_first_name": "NEDAL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-992-8205"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "354441301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brandy Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Brandy Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jill W. Bracken, D.O.
• Robert Wayne Bradley, PSYCHOLOGIST
• Kara Emily Bradshaw, LPC
• David W Bragg, M.D.
• Karol Brandenberger
• Robin Sue Brashier, RN
• Bravo Dental
• Bravo Smiles
• Brent Alan Brawley, D.D.S.
• Jaime Braziel, SLP

• Community/Retail Pharmacy in Garland, TX
• Providers in Garland, TX by specialty
• Community/Retail Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 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.