Healthcare Provider Details
I. General information
NPI: 1497841654
Provider Name (Legal Business Name): BROWN DRUG CO, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/05/2006
Last Update Date: 11/05/2025
Certification Date: 11/05/2025
Deactivation Date: 10/06/2006
Reactivation Date: 03/21/2008
III. Provider practice location address
101 SAMUEL O MOSELEY DR
SELMA AL
36701-6730
US
IV. Provider business mailing address
101 SAMUEL O MOSELEY DR
SELMA AL
36701-6730
US
V. Phone/Fax
- Phone: 334-874-9495
- Fax: 334-874-9929
- Phone: 334-874-9495
- Fax: 334-874-9929
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | 111878 |
| License Number State | AL |
VIII. Authorized Official
Name:
TIMOTHY
L
GIBBS
Title or Position: PRESIDENT
Credential:
Phone: 334-872-3255