Organization
BRANDY PHARMACY CORP
Active
Other names
Brandy Pharmacy 2
Organization subpart
No
Provider details
NPI number
Authorized official
NEDAL NASER (OWNER, AO)
(972) 773-9001
Entity
Organization
Contact information
Practice address
910 N GALLOWAY AVE STE 303, MESQUITE, TX 75149-2409
(972) 773-9001
(972) 773-9584
Mailing address
PO BOX 851766, MESQUITE, TX 75185-1766
(972) 773-9001
(972) 773-9584
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
31336
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2167300
PK
—
Enumeration date
01/17/2017
Last updated
11/27/2019
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