Individual provider · NPI-1

Brent Wayne Bandhan, PharmD

Pharmacist · Loxahatchee, FL

NPI number1386169084
StatusActive
Last updated in NPPESAug 3, 2017

Details

NPI
1386169084
Entity type
Individual (NPI-1)
Name
Brent Wayne Bandhan
Credential
PharmD
Sex
Male
Sole proprietor
No
Enumeration date
Aug 3, 2017
Last updated
Aug 3, 2017

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
183500000X PharmacistPS56718FLYes

Practice location

12001 Southern Blvd
Loxahatchee, FL 33470

Phone 561-784-7407

Mailing address

12001 Southern Blvd
Loxahatchee, FL 33470-4994

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