Organization
BRANSCOMB PHARMACY CORPORATION
Active
Organization
BRANSCOMB PHARMACY CORPORATION
Active
Other names
BRANSCOMB PHARMACY CORP
Organization subpart
No
Provider details
NPI number
Authorized official
IBUKUN BANDELE RPH (PRESIDENT)
(707) 984-8370
Entity
Organization
Contact information
Practice address
51 BRANSCOMB RD, #1, LAYTONVILLE, CA 95454-0016
(707) 984-8370
(707) 984-8372
Mailing address
PO BOX 16, LAYTONVILLE, CA 95454-0016
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY47525
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2115016
PK
—
05
—
PHA475250
—
CA
Enumeration date
08/10/2006
Last updated
07/14/2017
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