Healthcare Provider Details

I. General information

NPI: 1255735528
Provider Name (Legal Business Name): JOHN IRWIN BROWN RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/15/2014
Last Update Date: 10/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 CHEYENNE
SATANTA KS
67870-8748
US

IV. Provider business mailing address

401 CHEYENNE PO BOX 159
SATANTA KS
67870-8748
US

V. Phone/Fax

Practice location:
  • Phone: 620-649-2450
  • Fax: 620-649-2959
Mailing address:
  • Phone: 620-649-2450
  • Fax: 620-649-2959

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number1-15040
License Number StateKS

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: