Healthcare Provider Details

I. General information

NPI: 1497852230
Provider Name (Legal Business Name): S S BROWN ENTERPRISES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 01/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 S 8TH ST
MURRAY KY
42071-2400
US

IV. Provider business mailing address

PO BOX 1207
MURRAY KY
42071-0022
US

V. Phone/Fax

Practice location:
  • Phone: 270-753-2011
  • Fax: 270-753-1844
Mailing address:
  • Phone: 270-753-2011
  • Fax: 270-753-1844

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberP07016
License Number StateKY

VIII. Authorized Official

Name: WILLIAM BROWN
Title or Position: MEMBER/OWNER
Credential: RPH
Phone: 270-247-7300