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General NPI Number Information
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NPI Number | 1003229634
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Entity Type | Individual
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Provider Name | LORETTA BROWN
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Gender | Female
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Dates
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Enumeration Date | 06/11/2014
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Last Update Date | 06/11/2014
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Provider Practice Location Address
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Address Line | 1450 S YUMA PALMS PKWY TARGET
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City | YUMA
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State | AZ
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Zip | 85365
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Country | US
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Telephone | 928-785-7777
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Fax |
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Provider Business Mailing Address
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Address Line | 680 S 9TH AVE
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City | YUMA
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State | AZ
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Zip | 85364-2924
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Country | US
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Telephone | 928-785-7777
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 7613
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 32470
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License Number State | CA
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