Healthcare Provider Details

I. General information

NPI: 1598512543
Provider Name (Legal Business Name): ANDREW BROWNS DRUG STORE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2024
Last Update Date: 05/08/2024
Certification Date: 05/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1502 PITTSTON AVE
SCRANTON PA
18505-1668
US

IV. Provider business mailing address

1502 PITTSTON AVE
SCRANTON PA
18505-1668
US

V. Phone/Fax

Practice location:
  • Phone: 570-346-7319
  • Fax: 570-343-5850
Mailing address:
  • Phone: 570-346-7319
  • Fax: 570-343-5850

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MICHAEL P BROWN
Title or Position: PRESIDENT
Credential:
Phone: 570-346-7319