Healthcare Provider Details

I. General information

NPI: 1457324063
Provider Name (Legal Business Name): BROWN'S PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47 SULLIVAN ST
CANTON PA
17724-1729
US

IV. Provider business mailing address

47 SULLIVAN ST
CANTON PA
17724-1729
US

V. Phone/Fax

Practice location:
  • Phone: 570-673-4372
  • Fax: 570-673-7247
Mailing address:
  • Phone: 570-673-4372
  • Fax: 570-673-7247

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPP415334L
License Number StatePA

VIII. Authorized Official

Name: MR. JOHN SANFORD BROWN
Title or Position: OWNER
Credential: RPH
Phone: 570-673-4372