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General NPI Number Information
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NPI Number | 1235740952
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Entity Type | Individual
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Provider Name | RYAN BROWN PHARMD
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Gender | Male
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Dates
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Enumeration Date | 08/14/2020
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Last Update Date | 08/14/2020
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Provider Practice Location Address
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Address Line | W156N11261 PILGRIM RD
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City | GERMANTOWN
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State | WI
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Zip | 53022-3420
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Country | US
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Telephone | 262-253-9720
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Fax |
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Provider Business Mailing Address
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Address Line | W63N14268 WASHINGTON AVE APT 1
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City | CEDARBURG
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State | WI
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Zip | 53012-3012
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Country | US
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Telephone | 608-548-5723
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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 | 20460-40
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License Number State | WI
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