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General NPI Number Information
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NPI Number | 1497899447
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Entity Type | Organization
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Legal Business Name | BROWN DRUG STORE INC
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Dates
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Enumeration Date | 02/15/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 322 W WASHINGTON AVE
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City | ARTESIA
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State | NM
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Zip | 88210-2866
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Country | US
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Telephone | 505-746-3591
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Fax | 505-746-6673
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Provider Business Mailing Address
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Address Line | 322 W WASHINGTON AVE
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City | ARTESIA
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State | NM
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Zip | 88210-2866
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Country | US
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Telephone | 505-746-3591
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Fax | 505-746-6673
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Authorized Official
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Title or Position | PRESIDENT
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Name | DEBRA J RILEY
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Credential | RPH
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Telephone | 505-746-3591
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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 | 4621
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License Number State | NM
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