Healthcare Provider Details

I. General information

NPI: 1659979995
Provider Name (Legal Business Name): WILLIAM KIAH BROWN PHARMD.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2020
Last Update Date: 10/09/2020
Certification Date: 10/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2104 AL HIGHWAY 157
CULLMAN AL
35058-0656
US

IV. Provider business mailing address

2104 AL HIGHWAY 157
CULLMAN AL
35058-0656
US

V. Phone/Fax

Practice location:
  • Phone: 256-734-3146
  • Fax: 256-734-2179
Mailing address:
  • Phone: 256-734-3146
  • Fax: 256-734-2179

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number17042
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: