# BRENNCORP INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MIDTOWN PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1881768307
- **Authorized official:** MARSHALL WATERS (PRES)
- **Authorized official phone:** (251) 739-2424

## Contact information

- **Practice address:** 2152 AIRPORT BLVD, MOBILE, AL 36606-1756
- **Practice address phone:** (251) 479-2424
- **Practice address fax:** (251) 479-5234
- **Mailing address:** 2152 AIRPORT BLVD, MOBILE, AL 36606-1756
- **Mailing address phone:** (251) 479-2424
- **Mailing address fax:** (251) 479-5234

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 109668 | AL | Yes |

## Other

- **Enumeration date:** 11/17/2006
- **Last updated:** 08/23/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0119366 | NCPDP PROVIDER IDENTIFICATION NUMBER | — |
| 05 | — | 100002231 | — | AL |