Healthcare Provider Details

I. General information

NPI: 1134252547
Provider Name (Legal Business Name): GRANT HAROLD BROWN PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 12/11/2024
Certification Date: 12/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2136 ROBINSON RD SUITE 2
JACKSON MI
49203-3557
US

IV. Provider business mailing address

1410 W GANSON ST
JACKSON MI
49202-4063
US

V. Phone/Fax

Practice location:
  • Phone: 517-750-2180
  • Fax: 517-750-2181
Mailing address:
  • Phone: 517-789-7971
  • Fax: 517-789-0115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302024309
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: