=====================================================
General NPI Number Information
=====================================================
NPI Number | 1235504820
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BROWN PHARMACY, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/08/2015
-----------------------------------------------------
Last Update Date | 10/25/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1194 NEW HIGHWAY 52 E
-----------------------------------------------------
City | WESTMORELAND
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37186-5032
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 615-644-0102
-----------------------------------------------------
Fax | 615-644-0104
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1194 NEW HIGHWAY 52 E
-----------------------------------------------------
City | WESTMORELAND
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37186-5032
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 615-644-0102
-----------------------------------------------------
Fax | 615-644-0104
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHARMACIST IN CHARGE
-----------------------------------------------------
Name | DR. RACHAEL WILLIAMS
-----------------------------------------------------
Credential | D.PH.
-----------------------------------------------------
Telephone | 615-644-0102
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number | 5690
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------