DR. BRANDON PAUL BOURGEOIS (NPI# 1184240962) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184240962 |
| Entity Type | Individual |
| Full Name | DR. BRANDON PAUL BOURGEOIS |
| Credential | PHARMD, RPH |
| Practice Address |
9400 Mentor Ave Mentor OH 44060-4520 |
| Practice Telephone | 4402556247 |
| Practice Fax Number | 4402557203 |
| Mailing Telephone | 4402556247 |
| Mailing Fax Number | 4402557203 |
| Enumeration Date | 2020-06-17 |
| Last Update Date | 2020-06-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 03236547 | OH | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | OHIO BOARD OF PHARMACY | 03236547 | 01 |
| Street Address |
9400 MENTOR AVE |
| City | MENTOR |
| State | OH |
| Zip Code | 44060-4520 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306851324 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 9400 Mentor Ave, Mentor, OH 44060-4520 | 2006-07-29 |
| 1477164663 | Tyler J Merryman | Pharmacist | 9400 Mentor Ave, Mentor, OH 44060-4520 | 2020-08-12 |
| 1801342282 | Kelli Dawn Schafer | Pharmacist | 9400 Mentor Ave, Mentor, OH 44060-4520 | 2016-08-26 |
| 1962774539 | Michael John Broestl | Pharmacist | 9400 Mentor Ave, Mentor, OH 44060-4520 | 2012-01-30 |
| 1720358146 | Magdalene Marie Oshinsky | Pharmacist | 9400 Mentor Ave, Mentor, OH 44060-4520 | 2012-01-02 |
| 1982980298 | Cathy Marie Dill | Pharmacist | 9400 Mentor Ave, Mentor, OH 44060-4520 | 2011-10-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093364143 | Pamela Adams | Technician | 6079 Center St, Mentor, OH 44060 | 2019-09-10 |
| 1255800298 | Brittani Joy Lumpkin | Community/Behavioral Health | 9220 Mentor Road., Mentor, OH 44060 | 2018-11-20 |
| 1043726763 | Sharon Bollinger | Counselor | 7232 Tyler Blvd., Mentor, OH 44060 | 2017-12-18 |
| 1255863635 | Mentor Health and Rehabilitation Center, Inc. | Skilled Nursing Facility | 8151 Norton Pkwy, Mentor, OH 44060 | 2017-04-03 |
| 1144695933 | Kirsten Lorek | Specialist/Technologist | 8400 Paddock Ct, Mentor, OH 44060 | 2015-12-06 |
| 1346638848 | Darlean Williams | Licensed Practical Nurse | 6477 Center Street, Mentor High School, Mentor, OH 44060 | 2015-01-06 |
| 1316357130 | Kathryn Arnette Romo | Speech-Language Pathologist | 6451 Center Street, Mentor Exempted Village Schools, Mentor, OH 44060 | 2014-05-01 |
| 1730599705 | Marianne. P. Kostiha | Registered Nurse | 6451 Center St., Mentor Public Schools, Mentor, OH 44060 | 2014-04-30 |
| 1558788190 | Jeanne Marie Markusic | Physical Therapist | 7687 Ellington Pl, Mentor, OH 44060 | 2014-03-20 |
| 1477979391 | Center for Advanced Vein Care LLC | Emergency Medicine | 7200 Mentor Avenue, Mentor, OH 44060 | 2014-03-17 |
| Find all providers in zip 44060 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891133625 | Frank James Szep | Pharmacist | 7295 Brookridge Ln, Mentor, OH 44060-6770 | 2013-06-14 |
| 1447573720 | Diane A Hershline | Pharmacist | 9200 Mentor Ave, Mentor, OH 44060-6479 | 2010-03-01 |
| 1699835728 | Vadim Bronshteyn | Pharmacist | 7796 Munson Rd, Mentor, OH 44060-3745 | 2006-12-11 |
| 1063013068 | Luke Truong | Pharmacist | 7353 Mentor Ave, Mentor, OH 44060-7523 | 2020-11-05 |
| 1356941074 | Joseph Bahmer | Pharmacist | 5600 Emerald Ct, Mentor, OH 44060-1869 | 2020-10-30 |
| 1912507559 | Melissa Brunecz | Pharmacist | 5600 Emerald Ct, Mentor, OH 44060-1869 | 2020-10-30 |
| 1245830173 | Christine Lee Madden | Pharmacist | 9303 Mentor Ave, Mentor, OH 44060-6413 | 2020-10-29 |
| 1477164663 | Tyler J Merryman | Pharmacist | 9400 Mentor Ave, Mentor, OH 44060-4520 | 2020-08-12 |
| 1306456538 | Jacquelyn Marie Bacchi | Pharmacist | 7796 Munson Rd, Mentor, OH 44060-3745 | 2020-08-03 |
| 1215563663 | Justin James Smith | Pharmacist | 7232 Justin Way, Mentor, OH 44060-4881 | 2020-03-18 |
| Find all providers in MENTOR | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.