Healthcare Provider Details

I. General information

NPI: 1770701799
Provider Name (Legal Business Name): JAMES R BROWN PHARM.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6104 BANCROFT CT NE
ALBUQUERQUE NM
87111-7241
US

IV. Provider business mailing address

6104 BANCROFT CT NE
ALBUQUERQUE NM
87111
US

V. Phone/Fax

Practice location:
  • Phone: 505-857-9696
  • Fax:
Mailing address:
  • Phone: 505-857-9696
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number00006496
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: