Provider Demographics
NPI:1023610912
Name:LI, BRANDON (PHARMD)
Entity type:Individual
Prefix:MR
First Name:BRANDON
Middle Name:
Last Name:LI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2035 E MARKET ST STE 115
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-8881
Mailing Address - Country:US
Mailing Address - Phone:540-442-7380
Mailing Address - Fax:
Practice Address - Street 1:2035 E MARKET ST STE 115
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-8881
Practice Address - Country:US
Practice Address - Phone:540-442-7380
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-15
Last Update Date:2020-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202217495183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist