Healthcare Provider Details

I. General information

NPI: 1700176724
Provider Name (Legal Business Name): JAMES E BROWN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2011
Last Update Date: 11/23/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

660 E BOISE AVE
BOISE ID
83706-5118
US

IV. Provider business mailing address

1804 E MONTEREY DR
BOISE ID
83706-6307
US

V. Phone/Fax

Practice location:
  • Phone: 208-336-8340
  • Fax:
Mailing address:
  • Phone: 208-336-8890
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberP3399
License Number StateID
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5245
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH7901
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: