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NPI Code Detail

MEDICARE: BROWNS IA LLC

MEDICARE: BROWNS IA LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1333600000XPharmacy
23336C0003XCommunity/Retail PharmacyPP481371PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
13983283OTHERNCPDP PROVIDER IDENTIFICATION NUMBER
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1134234925
Entity Type Code : Organization
Provider Name (Legal Business Name) : BROWNS IA LLC
Provider Business Mailing Address
First Line : PO BOX 15169
Second Line :
City : NEWARK
State : NJ
Zip : 07192
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2946 ISLAND AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19153-2026
Country : US
Telephone Number : 215-937-0327
Fax Number : 215-492-1835
Authorized Official
Title or Position : THIRD PARTY ADMINISTRATOR
Name : MELISSA FIGUEROA RIVERA
Credential :
Telephone Number : 732-521-8439
Provider Enumeration Date : 08/20/2006
Last Update Date : 07/13/2017

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