Individual
BRIAN E RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1195 BARRETT BLVD UNIT 2, HENDERSON, KY 42420-7508
(270) 826-6036
Mailing address
2111 PEBBLE BEACH DR, NEWBURGH, IN 47630-8415
(618) 920-3460
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051296811
IL
Other
Enumeration date
11/03/2020
Last updated
11/03/2020
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