Healthcare Provider Details

I. General information

NPI: 1285880666
Provider Name (Legal Business Name): TERRENCE HOUSTON BROWN PHARM. D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2008
Last Update Date: 05/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 BUSINESS PARK DR STE D
RIDGELAND MS
39157-6015
US

IV. Provider business mailing address

100 BUSINESS PARK DR STE D
RIDGELAND MS
39157-6015
US

V. Phone/Fax

Practice location:
  • Phone: 601-956-6228
  • Fax:
Mailing address:
  • Phone: 601-956-6228
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH023879
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License NumberT-010881
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: