Brockhouse, Jamie J

Brockhouse, Jamie J is an individual health care provider with primary practice located at 1001 Heather Dr , Mahomet IL 61853-2754. She recently has only one registered license in Pharmacy Service Providers / Pharmacotherapy, which is considered as her primary health care specialty. Brockhouse, Jamie J can be contacted via phone (217) 586-8474.

Contact Information

Primary practice address
1001 Heather Dr Mahomet IL 61853-2754
Phone: (217) 586-8474
Fax: (217) 586-8475
Website:
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Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacotherapy 1835P1200X Illinois

Profile Details

NPI number 1811052210
LBN Legal business name Brockhouse, Jamie J
Credentials RPH
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 26th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811052210 NPPES
Illinois MEDICAID 371119538020

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