Organization
BRANDT PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA COURTNEY (MGR)
(815) 568-7331
Entity
Organization
Contact information
Practice address
101 N STATE ST, MARENGO, IL 60152-2217
(815) 568-7242
(815) 568-0428
Mailing address
101 N STATE ST, MARENGO, IL 60152-2217
(815) 568-7242
(815) 568-0428
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
054004373
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2022580
PK
—
Enumeration date
05/09/2007
Last updated
06/01/2018
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