Healthcare Provider Details

I. General information

NPI: 1871933242
Provider Name (Legal Business Name): PATRICK BROWN PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2013
Last Update Date: 07/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270 COPPERFIELD BLVD NE
CONCORD NC
28025-2441
US

IV. Provider business mailing address

105 SUMMERLAKE DR SW
CONCORD NC
28025-5767
US

V. Phone/Fax

Practice location:
  • Phone: 704-784-9613
  • Fax: 704-789-9366
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number23243
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: