Healthcare Provider Details

I. General information

NPI: 1629997333
Provider Name (Legal Business Name): BERAH LATEEFAH BROWN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 JEFFERSON AVE
TOLEDO OH
43604-7101
US

IV. Provider business mailing address

730 RIVERSIDE DR APT 220
TOLEDO OH
43605-5610
US

V. Phone/Fax

Practice location:
  • Phone: 419-251-4810
  • Fax:
Mailing address:
  • Phone: 330-550-8361
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03445780
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: