NPI 1053721852

Beth Ann Longbrake

Practitioner Pharmacotherapy Pharmacist Mishawaka, IN

Practice location

Address: 5020 Grape Rd, Mishawaka, IN 46545-8708
Phone: (574) 273-3533
Fax: (574) 273-3565

Registered specialties

Pharmacotherapy Pharmacist Primary

Pharmacy Service Providers Taxonomy 1835P1200X Licence 26019104A (IN)

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Registry record

NPI: 1053721852
Entity type: Individual
Sex (as registered): Female
NPI issued: 1 May 2014
Record last updated: 1 May 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.